Vomiting and fever in a child without diarrhea

Symptoms such as vomiting, diarrhea, fever in a child are associated by parents with an intestinal infection. As a rule, all adults have first aid skills in this situation, are aware of the dangers of the disease, are able to assess the condition and independently take emergency measures or seek help from a doctor. And if a child has vomiting and fever without diarrhea, what could it be?

Epidemiology

It is difficult to judge the epidemiology of nausea, vomiting, and fever in children, since these symptoms indicate a different nature of their occurrence and are inherent in many diseases. There are some statistics that allow us to get a remote picture of the prevalence of these signs of pathology. Thus, up to a quarter of all children suffer from pancreatitis and various gastrointestinal diseases. It is difficult to judge the prevalence of food poisoning, since many do not seek medical help if the symptoms are not life-threatening. Cases of acute appendicitis are 5 units per 1000 people of the entire population. Most often, adolescents over 15 years of age were operated on. From 10 to 25% of children experienced an exacerbation of internal organ diseases, including nausea and vomiting, during prolonged stress.

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Causes vomiting with fever in a child without diarrhea

The causes of vomiting and fever without diarrhea in a child may be as follows:

• food poisoning;
• product incompatibility;
• severe stress leading to nervous disorders;
• pathologies of the central nervous system (brain tumors, traumatic brain and birth injuries, increased intracranial pressure, meningitis, encephalitis);
• disorders of the digestive organs (acute gastritis, intestinal stenosis, polyps, neoplasms, pancreatitis, cholecystitis, etc.);
• swallowed foreign body;
• acute appendicitis;
• renal failure;
• reaction to taking medications.

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Risk factors

Risk factors for the development of nausea and vomiting, sometimes accompanied by an increase in temperature, include:

• weak vestibular system;
• type of nervous system, namely, unbalanced, easily excitable;
• obesity;
• gastric hypotension;
• surgical operations localized in the area of excitation of the vomiting center;
• previous anesthesia, especially if a long operation was performed;
• diabetes mellitus.

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Pathogenesis

Each pathology that causes this condition has its own pathogenesis. Common features include nausea and vomiting, which are of great clinical importance because they can lead to serious consequences. Due to the difference in the tone of the muscles of the stomach and duodenum (the latter is higher) and weak peristalsis of the stomach, the contents of the small intestine enter it. In addition, the urge to vomit causes contraction of the muscles of the diaphragm and respiratory organs. Vomiting is a complex sequence of involuntary reflexes, as a result of which the esophageal sphincter contracts, pushing everything that is in the stomach into the oral cavity. Vomiting is often accompanied by sweating, pale skin, and irregular heartbeat. This entire process is coordinated by the vomiting center.

An increase in body temperature is caused either by an imbalance between heat production and heat transfer, or, in the case of normal heat production, by disruptions in heat transfer.

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Symptoms vomiting with fever in a child without diarrhea

Symptoms of vomiting and fever without diarrhea in a child vary depending on the causes. The first signs may appear suddenly - acute nausea and vomiting are typical of food or drug poisoning, head injuries, infections, including intestinal ones. Later, body temperature rises. With obstruction of the digestive organs, disorders of their motility, psychogenic disorders, high intracranial pressure, wave-like attacks occur. The appearance of nausea and vomiting during or immediately after eating indicates neurotic disorders, in the morning - about malfunctions of the gallbladder. In case of an increase in temperature with a balance of heat production and heat transfer, the child's skin is pink, warm, there is no "goose bumps" when wiping it with cold water, the limbs are also warm, there is no tachycardia. Another option is pale fever, which occurs when the heat transfer mechanism is disrupted. This variant is characterized by high temperature, cold extremities, tachycardia, and pale skin.

Stages

The stages of the vomiting process are as follows: nausea, vomiting urges and vomiting. Nausea is perceived by a person as an unpleasant sensation arising in the epigastric region and in the larynx. During vomiting urges, various muscles are involved: the diaphragm, the anterior abdominal wall and others, they contract convulsively, while the vomit comes out through the mouth. Children experience the act of vomiting painfully, it frightens them, causing physical and psychological discomfort.

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Forms

There are two types of triggering the vomiting mechanism. One of them is the hypothalamus receiving impulses from the peritoneum, pharynx, and vestibular apparatus of the digestive tract. The other is associated with stimulation of the so-called chemoreceptor trigger zone, which also sends a signal to the vomiting center. Its stimulants can be drugs, complications of diabetes, radiation therapy, hypoxia, uremia, etc.

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Complications and consequences

Nausea, vomiting and fever, being symptoms of various pathologies of the body, significantly aggravate the course of the disease. The consequences and complications of severe vomiting, high temperature pose a danger to the child's life, since this disrupts the water-electrolyte balance. Violent vomiting can damage the mucous membrane of the cardiac section of the stomach, which leads to bleeding. Repeated vomiting has the most adverse effect on the body, resulting in metabolic disorders (alkalosis, hypokalemia and hyponatremia), entailing the loss of potassium and sodium.

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Diagnostics vomiting with fever in a child without diarrhea

Diagnosis of vomiting and fever without diarrhea is not an easy process, because such symptoms may hide many possible diagnoses. Therefore, it is important to collect a complete anamnesis from the parents. Facts such as how long ago such symptoms began, what food the patient ate, whether he took medications play a big role. It is necessary to find out the ratio of vomiting and food intake, the relationship between the appearance of pain, temperature and vomiting, the smell of vomit, its contents. Abdominal palpation, collection of material for analysis, instrumental examination are also carried out if the doctor sees the appropriateness of this.

With these symptoms, a general blood test is performed to check for leukocytes, ESR, hemoglobin, with an assessment of lymphocytosis and eosinophilia. A biochemical analysis determines the level of protein, transaminases, electrolytes, urea, glucose, alkaline phosphatase, creatinine, etc. A urine test is required to detect kidney pathology, and a coprological study of feces is the most important study if there is a suspicion of gastrointestinal tract pathology. It will give a picture of how the processes of digestion of food and absorption of nutrients occur as a result of digestion.

Instrumental diagnostics are very important for clarifying the diagnosis. It includes ultrasound of the abdominal organs and kidneys, X-ray of the upper gastrointestinal tract, fibroesophagogastroduodenoscopy. Additional methods include electrocardiogram, CT and MRI of the brain.

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Differential diagnosis

A thorough anamnesis is necessary for preliminary localization of the disease focus, its differential diagnosis. The time of vomiting in relation to food intake gives a hint, which was mentioned when considering the symptoms of the pathology. Concomitant symptoms also play a large role: dizziness (characteristic of Meniere's disease), headache (migraine, arterial hypertension), etc. The nature of the vomit says a lot: mucus indicates gastritis, pus - gastric phlegmon, bile - duodenogastric reflux, blood fragments - an ulcer, a putrid odor - peritonitis, etc.

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Treatment vomiting with fever in a child without diarrhea

The main task in treating vomiting and fever without diarrhea in a child is to prevent complications. Parents should ensure that the child does not choke on vomit. To do this, he must be laid on his side. If the vomiting act is isolated and the body temperature is low, then you can observe his condition without calling a doctor. To prevent dehydration, you need to give plenty of fluids. Depending on age, a different daily dose will be required, but it can be approximately determined at the rate of 100 ml per kilogram of the child's weight. If vomiting is repeated and the condition worsens, you must urgently call a doctor or even an ambulance. The primary task of doctors is to stop vomiting with antiemetics, reduce the temperature to a non-critical level, and correct electrolyte imbalances. Further actions are aimed at treating the underlying cause that caused such symptoms.

Medicines

Antiemetic drugs, drugs that reduce temperature and drugs aimed at a specific disease are used for treatment, depending on the diagnosis. It is necessary to adhere to one rule: all medications are prescribed only by a doctor, self-medication can harm your child's health. To stop vomiting spasms, children over 3 years old are usually prescribed cerucal.

Cerucal has an antiemetic effect, except for vomiting of psychogenic and vestibular nature. The drug normalizes the tone of the digestive organs. Refers to dopamine receptor blockers. Available in tablets and injection solutions. The dose for children over three years old is determined at the rate of 0.1 mg / kg of weight. Tablets are taken 30 minutes before meals 3-4 times a day. For adolescents, the norm is higher - 10 mg. Treatment lasts from one month to six months. When using the drug, side effects are possible from the central nervous system - headache, tinnitus, dizziness, fear, anxiety; gastrointestinal tract - dry mouth, stool disorders; cardiovascular system - tachycardia, changes in blood pressure. Do not prescribe for bronchial asthma, intestinal obstruction, gastric bleeding, epileptic seizures, allergies.

Indications for antipyretic therapy are body temperature above 38.5 ⁰, convulsions, fever, lower temperature readings, if the child's health deteriorates or there are concomitant diseases of other systems. Most often, paracetamol, analgin, and cefecon suppositories are used as antipyretic agents.

Cefekon is a suppository, administered rectally after defecation or a cleansing enema. It is used from 3 months to 12 years. The dose is calculated depending on the child's weight, divided into 2-3 doses, but not more than 60 mg / kg per day. As a rule, the drug is well tolerated by children, nausea, diarrhea, skin rash were rarely observed. There are contraindications for hypersensitivity to the drug, impaired renal and hepatic function.

A disease such as pancreatitis - inflammation of the pancreas, is treated with analgesics, antispasmodics, pancreatic enzymes. In severe cases, antibiotics, antihistamines, etc. may be used.

Pancreatin for children is an enzyme preparation made from the pancreas of animals. It is a round, film-coated tablet. It is taken before or during meals without chewing. The dose depends on the child's age: for children 3-5 years old - 1 tablet; 6-7 years - 1-2; 8-9 years - 2; 10-14 years - 2-4 tablets. Side effects were noted in less than 1% of children taking the drug. These were allergies, diarrhea, nausea, constipation. It is not prescribed to children under three years of age.

In case of various intestinal infections, food poisoning, it becomes necessary to prescribe antibiotics.

Amoxicillin is a broad-spectrum antibiotic from the penicillin group. It is available in tablets and a more convenient form for use - suspension. Children from 2 to 5 years old are recommended 0.125 g three times a day, up to two years - 20 mg / kg divided into 3 doses. After 5 years, 0.25 g is prescribed three times a day, over 10 years and weighing more than 40 kg - 0.5 g in one dose with the same frequency. Side effects may occur in the form of conjunctivitis, rhinitis, fever. The drug has contraindications for people sensitive to penicillins.

In stressful situations that lead to nausea, vomiting, and fever, pediatricians resort to the use of tranquilizers (diazepam, neoazepam) and neuroleptics (haloperidol, etapirozine).

Diazepam - tablets, the dose for children under 3 years is calculated individually, based on weight, after this age - 2.5 mg 3 times a day. As a rule, they start with the minimum, gradually increasing. The drug causes side effects: drowsiness, apathy, depression, dry mouth, nausea, sometimes jaundice. Contraindicated in diseases of the liver, kidneys, cardiovascular system, hypersensitivity to the components of the drug.

Symptoms caused by taking medications are also eliminated by neuroleptics (chlorpromazine, prochlorperazine).

Chlorpromazine is available in the retail network in tablets, dragees and ampoules for injections. The daily dose for children is 1 mg / kg of weight, when determining it, the doctor individually approaches each patient. It is used after meals. Allergies, decreased blood pressure, dyspeptic phenomena may occur. Contraindicated in case of head injuries, liver and kidney dysfunction, hematopoietic organs.

Vitamins

It is believed that in case of severe toxicosis in pregnant women, taking vitamin B6 (pyridoxine) gives good results. This gives grounds to believe that in case of nausea and vomiting in children, provided that the required doses are observed and under the supervision of a doctor, taking this vitamin is also possible. The maximum doses for different age groups are as follows: 1-3 years - 30 mg, 4-8 years - 40 mg, 9-13 years - 60 mg, after 14 years - 80 mg. In addition to vitamin B6, other vitamins of this group, as well as A, C, E, are also useful for good growth and full functioning of all body systems. In addition to vitamins, nutrition should contain various microelements necessary for a growing person. During vomiting, magnesium is excreted from the body, its deficiency aggravates the condition, so complexes containing vitamin B6 and magnesium are very suitable in this situation.

Physiotherapy treatment

Physiotherapeutic treatment of pathological conditions accompanied by nausea, vomiting, fever, after the acute symptoms have been relieved, may include the use of electrosleep, laser and acupuncture, hypnosis, electrophoresis with novocaine, vitamin B1, diphenhydramine. Psychotherapy, exercise therapy, and various water treatments, such as mineral and herbal baths, are also effective.

Folk remedies

In folk medicine recipes there are ways to prepare antiemetic potions, they will not cause harm, but since we are talking about children, you should not rely on them too much and delay calling a doctor. Here are some of them:

• add grated lemon zest to cold boiled water, let it brew for 30 minutes, drink in small sips;
• boil the quince, grate it and eat it;
• drink a spoonful of raw potato juice before eating;
• chew green tea leaves or drink tea made from it.

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Herbal treatment

Herbs such as peppermint, lemon balm, valerian root, and henbane have long been considered remedies for nausea and vomiting. They are used to make infusions and taken before meals to reduce the urge to vomit. An effective remedy is also an infusion of dried maple leaves, and a decoction of dill seeds will help with symptoms caused by stomach diseases.

Homeopathy

There are both individual homeopathic components and complex preparations used for nausea and vomiting. Their action is aimed at activating the body's defenses. You can use complex homeopathic remedies: gastricumel, duodenohel, vertihogel, nux vomica gomaccord, spascuprel. Single-component ones include: antimonium crudum (used for vomiting after overeating), anacardium (vomiting on an empty stomach), arcenicum album (the sight and smell of food cause disgust), coccullus indicus (with a weak vestibular apparatus), ipecacuanha (vomiting after eating, accompanied by tachycardia), creosotum (vomiting due to neoplasms), tabacum (dizziness with vomiting), etc.

Duodenohel is a lozenge that reduces the production of hydrochloric acid. It is used for nausea and vomiting in gastritis and gastroduodenitis with increased acidity. The dose is determined individually, the minimum is a tablet three times a day. Contraindicated for children under 4 years of age. A side effect with allergic manifestations is possible.

Vertihogel is indicated for symptoms of vascular, neurogenic origin, and concussion. Release form - drops and injection solution (administered intramuscularly, subcutaneously, and intravenously). For children aged 1-3 years, a quarter of an ampoule or 3 drops per spoon of water is injected orally; for 3-6 years - half an ampoule or 5 drops orally, from 6 years and older - an ampoule or 10 drops. The course of treatment is from three weeks to one and a half months. There are no contraindications and side effects.

Nux vomica gomaccord - drops, used for vomiting due to migraines, gastrointestinal pathologies. Children under 2 years old are dripped into water 9 drops per day, from 2 to 6 years - 15, over 6 years - 30. Allergic reactions are possible with individual intolerance to the components of the drug.

Spascuprel - tablets under the tongue, intended for resorption. Before taking by children under 3 years old, a doctor's consultation is required. The dose is 3 tablets per day. The duration of treatment can be up to three weeks.

What all the described drugs have in common is the method of administration: 20-30 minutes before meals or an hour after.

Surgical treatment

In some diseases that cause symptoms of nausea and vomiting, only surgical treatment is the only possible option to save the patient's life. We are talking about acute appendicitis. Surgical intervention is also possible if the treatment of pancreatitis in children is ineffective; sometimes they resort to pancreatic resection, necrectomy (removal of non-viable tissue), cholecystectomy (removal of the gallbladder), etc. Neoplasms of the brain and digestive organs also require surgical treatment.

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Prevention

Prevention of various diseases accompanied by the described symptoms is the responsibility of parents. They must organize healthy and regular nutrition, observe hygiene rules when preparing food to avoid various food infections, helminthic invasions, monitor the intake of medications, and not leave children unattended. If symptoms appear, take them seriously and seek help from a doctor.

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Forecast

Nausea, vomiting, fever do not always have a favorable outcome for the patient. Rupture of the appendix of the cecum leads to abdominal abscesses, peritonitis, sepsis, which are extremely dangerous for the child's health. In hemorrhagic or purulent pancreatitis, there is also a high risk of death. Diseases such as meningitis and encephalitis are also very dangerous, the prognosis for recovery depends on the speed of the therapy started.

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