Vomiting and fever in a child without diarrhea

Symptoms such as vomiting, diarrhea, and temperature in the child are associated with intestinal infection in the parents. 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 take emergency measures on their own or call for help from a doctor. And if the child has vomiting and fever without diarrhea, what can it be?

Epidemiology

To judge about the epidemiology of nausea, vomiting, fever in children is not easy, tk. These symptoms indicate a different nature of their occurrence and are inherent in many diseases. There are separate statistical data that allow to obtain a remote picture of the prevalence of these signs of pathology. So, on patients with pancreatitis and with various diseases of the gastrointestinal tract account for up to a quarter of all children. The prevalence of food poisoning is difficult to judge, because many do not go to medical institutions for help if the symptoms do not threaten life. Cases of acute appendicitis are 5 units per 1000 people of the total population. Most often, teenagers were operated after 15 years. From 10 to 25% of children under prolonged stress experienced an exacerbation of internal diseases, including nausea with vomiting.

[1], [2], [3], [4], [5]

Causes of the vomiting with fever in a child without diarrhea

The reasons for vomiting and temperature without diarrhea in a child can be as follows:

• food poisoning;
• product incompatibility;
• severe stress, leading to nervous disorders;
• pathology of the central nervous system (brain tumors, craniocerebral and birth trauma, increased intracranial pressure, meningitis, encephalitis);
• disturbances in the work of the digestive organs (acute gastritis, intestinal stenosis, polyps, neoplasms, pancreatitis, cholecystitis, etc.);
• swallowed foreign body;
• acute appendicitis;
• kidney failure;
• reaction to medication.

[6], [7]

Risk factors

The risk factors for nausea, vomiting, sometimes accompanied by an increase in temperature, include:

• weak vestibular apparatus;
• type of nervous system, namely, unbalanced, easily excitable;
• obesity;
• hypotension of the stomach;
• surgical operations localized in the field of excitation of the vomiting center;
• anesthesia, especially if a prolonged operation was performed;
• diabetes.

[8]

Pathogenesis

Pathogenesis in each of the pathologies that caused this condition, its own. Common is nausea, vomiting, which are of great clinical importance, because can lead to serious consequences. Because of the difference in the tone of the muscles of the walls of the stomach and duodenum (the latter has a higher one) and a weak peristalsis of the stomach, the contents of the small intestine enter it. In addition, the urge to vomit causes a 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 into the oral cavity all that is in the stomach. Vomiting is often accompanied by sweating, pallor of the skin, irregularities in the work of the heart. The entire process is coordinated by the emetic center.

The rise in body temperature is caused either by an imbalance in the production of heat and heat transfer, or, in the case of normal heat production, by failures in heat transfer.

[9], [10], [11], [12],

Symptoms of the vomiting with fever in a child without diarrhea

Symptoms of vomiting and temperature without diarrhea in the child, depending on the causes that gave rise to them, are different. The first signs can occur suddenly - acute nausea and vomiting is typical for food or drug poisoning, head injuries, infections, including intestinal infections . Later, the body temperature rises. When the obstruction of the digestive organs, disorders of their motor skills, psychogenic disorders, high intracranial pressure, wave-like attacks develop. Occurrence of nausea and vomiting with food or immediately after it indicates neurotic disorders, in the morning hours - about failures in the operation of the gallbladder. In the case of an increase in temperature at the equilibrium of heat production and heat transfer, the baby's skin is pink, warm, there is no goosebump when rubbing it with cold water, limbs are also warm, there is no tachycardia. Another option - pale fever, occurs when the heat transfer mechanism is broken. This variant is characterized by high fever, cold extremities, tachycardia, pale skin.

Stages

The stages of the emetic process are as follows: nausea, urge to vomit and vomiting. Nausea is perceived by a person as an unpleasant sensation arising in the epigastric region and in the larynx. During the vomiting, various muscles are involved: the diaphragm, the anterior abdominal wall and others, their convulsive contraction occurs, and the vomit goes out through the mouth. Children painfully suffer from gagging, it scares them, bringing physical and psychological discomfort.

[13], [14], [15]

Forms

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

[16], [17], [18], [19]

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 fever are a danger to the life of the child, because while the water-electrolyte balance is disturbed. From violent vomiting, damage to the mucous membrane of the cardiac part of the stomach is possible, which leads to bleeding. The most adverse effect on the body is repeated vomiting, resulting in metabolic disorders (alkalosis, hypokalemia and hyponatremia), leading to loss of potassium and sodium.

[20], [21], [22]

Diagnostics of the vomiting with fever in a child without diarrhea

Diagnosis of vomiting and temperature without diarrhea is not an easy process, because for such symptoms lies many possible diagnoses. Therefore, it is important to collect anamnesis from parents in full. A great role is played by the facts, how long began such manifestations, what food the patient used, whether he took the medicines. It is necessary to clarify the ratio of vomiting and eating, the relationship of the appearance of pain, temperature and vomiting, the smell of vomit, their contents. There is also palpation of the abdomen, collection of material for analysis, instrumental research, if the doctor sees the feasibility of this.

With this symptomatology, a general blood test is performed for the presence of leukocytes, for ESR, hemoglobin, with evaluation of lymphocytosis, eosinophilia. Biochemical analysis determines the level of protein, transaminases, electrolytes, urea, glucose, alkaline phosphatase, creatinine, etc. Mandatory urinalysis, which will reveal the pathology of the kidneys, and coprologic examination of stool - the most important study for suspected pathology of the gastrointestinal tract. It will give a picture of the processes of digestion of food and absorption of nutrients as a result of digestion.

Instrumental diagnosis is very important for clarifying the diagnosis. It includes ultrasound of the abdominal cavity and kidneys, X-rays of the upper gastrointestinal tract, fibro-esophagogastroduodenoscopy. Additional methods include electrocardiocardiogram, CT and MRI of the brain.

[23], [24], [25], [26], [27]

Differential diagnosis

Careful collection of anamnesis is necessary for the preliminary localization of the focus of the disease, its differential diagnosis. The time of the onset of vomiting with regard to food intake gives a clue, which was mentioned when considering the symptoms of pathology. A great role is played also by accompanying manifestations: dizziness (typical for Meniere's disease), headache (migraine, arterial hypertension), etc. The nature of the vomiting suggests a lot: mucus points to gastritis, pus to phlegmon of the stomach, bile to duodenogastric reflux, fragments of blood - on ulcer, putrefactive smell - on peritonitis, etc.

[28], [29],

Treatment of the vomiting with fever in a child without diarrhea

The main task in the treatment of vomiting and fever without diarrhea in a child is the prevention of complications. Parents should take care of that the child is not choked with vomit masses. To do this, it must be put to one side. If the emetic act is single and the body temperature is low, you can observe its condition without calling a doctor. To prevent dehydration of the body, you must give abundant drink. Depending on the age, a different daily dose will be required, but approximately it can be determined from the calculation of 100ml per kilogram of the child's weight. If vomiting is multiple, and the condition worsens, it is urgent to call a doctor or even an ambulance. The paramount task of physicians to stop vomiting with anti-emetics, to lower the temperature to not critical, to correct electrolyte disturbances. Further actions are directed to treatment of the underlying cause that caused such symptoms.

Medications

For the treatment of antiemetics, drugs that reduce temperature and are aimed at a particular disease, 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 cure vomiting spasms, children older than 3 years are usually prescribed a cerucal.

Cerucal - has antiemetic effect, except for vomiting of psychogenic and vestibular character. The drug normalizes the tone of the digestive organs. Refers to blockers of dopamine receptors. Available in tablets and injectable solutions. The dose for children after three years is determined from the calculation of 0.1 mg / kg of weight. Tablets are taken for 30min. Before meals 3-4 times a day. For teenagers the norm is higher - 10 mg. Treatment lasts from a month to six months. When using the drug, side effects from the CNS are possible - headache, tinnitus, dizziness, a sense of fear, anxiety; Gastrointestinal tract - dry mouth, stool; cardiovascular system - tachycardia, changes in blood pressure. Do not appoint for bronchial asthma, intestinal obstruction, gastric bleeding, seizures of epilepsy, allergies.

Indications for antipyretic therapy are body temperature above 38,5 ⁰, convulsions, fever, lower temperature indices, if the child's health is deteriorating or there are concomitant diseases of other systems. Most often as antipyretic agents used paracetamol, analgin, cefekonovye candles.

Cefepon is a suppository, it is injected rectally after defecation or cleansing enema. Applies from 3 months to 12 years. The dose is calculated depending on the weight of the child, 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, and skin rash were rare. There are contraindications for hypersensitivity to the drug, violations of kidney and liver.

This disease, like pancreatitis - inflammation of the pancreas, is treated with analgesics, spasmolytics, pancreatic enzymes. In severe cases, antibiotics, antihistamines, and others can be used.

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

In the 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 produced in tablets and more convenient for application form - suspension. Children from 2 to 5 years are recommended to 0.125 g three times a day, up to two years - 20 mg / kg divided into 3 receptions. After 5 years, appoint 0.25 g three times a day, over 10 years and weighing more than 40 kg - 0.5 g in one dose at the same frequency. There may be side effects in the form of conjunctivitis, rhinitis, fever. The drug has contraindications for people with sensitivity to penicillins.

In stressful situations that lead to nausea, vomiting, fever in pediatrics, tranquilizers (diazepam, neozepam) and neuroleptics (haloperidol, etapyrosine) are used.

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, begin with a 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.

Symptomatics caused by taking medicines is also eliminated by neuroleptics (chlorpromazine, prochlorperazine).

Chlorpromazine - in the sales network is presented in tablets, dragees and ampoules for injections. The daily dose for children is 1 mg / kg of weight, with its definition, the doctor individually suits every patient. It is used after eating. Allergies, depression of pressure, diarrheal phenomena can be shown. Contraindicated in head injuries, violations of the liver and kidneys, hematopoietic organs.

Vitamins

It is believed that with severe toxemia in pregnant women, a good result is the intake of vitamin B6 (pyridoxine). This gives grounds to believe that with the nausea and vomiting in children, provided that the necessary doses and under the supervision of a doctor, it is also possible to take this vitamin. 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 and E. Are useful for good growth and full functioning of all body systems. Nutrition should contain in addition to vitamins and various trace elements 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.

Physiotherapeutic treatment

Physiotherapeutic treatment of pathological conditions accompanied by nausea, vomiting, fever, after the removal of acute symptoms can be the use of electrosleep, laser and acupuncture, hypnosis, electrophoresis with novocaine, vitamin B1, diphenhydramine. Psychotherapy, physiotherapy exercises, various water procedures - mineral and herbal baths are also effective.

Alternative treatment

In the recipes of alternative treatment, there are ways to prepare antiemetic drugs, they will not do harm, but because we are talking about children, then strongly rely on them and delay the doctor's call is not worth it. Here are a few of them:

• grated lemon zest, add to cold boiled water, give 30 minutes. Brew, drink in small sips;
• boil the quince, rub and eat;
• Before eating, drink a spoonful of raw potato juice;
• chew the leaves of green tea or drink tea from it.

Herbal Treatment

Such herbs as peppermint, lemon balm, valerian root, bleach have long been considered a means to treat nausea and vomiting. They make infusions, take before meals to reduce the urge to vomit. An effective remedy is the infusion of dried maple leaves, and a decoction of dill seeds will help with symptoms caused by gastric diseases.

Homeopathy

There are both separate homeopathic components, and complex preparations used for nausea and vomiting. Their action is aimed at activating the protective functions of the body. You can use complex homeopathic remedies: gastricumel, duodenocel, vertihogel, nuks vomica homaccord, rescue. One component includes: antimonium crudum (used for vomiting after overeating), anacardium (vomiting on an empty stomach), arsenicum album (the appearance and smell of food is disgusting), coccullus indicus (with a weak vestibular apparatus), ipecacuanha (vomiting after eating accompanied by tachycardia), kreosotum (vomiting due to neoplasms), tabacum (dizziness with vomiting), etc.

Duodenogel - tablets for resorption, reducing the production of hydrochloric acid. It is used for nausea and vomiting in gastritis and gastroduodenitis with high acidity. The dose is determined individually, the minimum is a tablet three times a day. Contraindicated in children under 4 years. There is an adverse reaction with allergic manifestations.

Vertichogel - is indicated for symptomatic of vascular, neurogenic origin, with concussion of the brain. The form of release - drops and a solution for injections (it is entered intramuscularly, subcutaneously and intravenously). For children 1-3 years old, the fourth part of the ampoule is curled or 3 drops per spoon of water orally; for 3-6 years - a half ampoule or 5 drops through the mouth, 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.

Nuks vomica homaccord - drops, are used for vomiting due to migraines, gastrointestinal pathologies. Children under 2 years drip on water 9 drops per day, from 2 to 6 years - 15, over 6 years - 30. Allergic manifestations are possible with individual intolerance of the drug components.

Spazkuprel - tablets under the tongue, designed for resorption. Before taking children up to 3 years of age, a doctor's consultation is necessary. The dose of 3 tablets during the day. The duration of treatment can be up to three weeks.

Common to all described drugs is their way of taking: 20-30 minutes before meals, or an hour after.

About treatment

With some diseases that cause symptoms of nausea and vomiting, only surgical treatment is the only possible option to save a patient's life. It's about acute appendicitis. Surgical intervention is also possible with ineffective treatment of pancreatitis in children, sometimes resort to pancreas resection, necrectomy (removal of nonviable tissues), cholecystectomy (removal of the gallbladder), etc. Neoplasms of the brain, digestive organs also require surgical treatment.

[30], [31], [32]

Prevention

Prevention of various diseases, accompanied by the described symptoms - this is the area of responsibility of parents. They should organize healthy and regular meals, observe hygiene rules during cooking, to avoid various food infections, helminthic invasions, monitor the intake of medicines, and not leave children unattended. In case of symptoms, treat them with all seriousness and seek medical help from a doctor.

[33], [34], [35], [36], [37]

Forecast

Nausea, vomiting, and temperature do not always have a favorable outcome for the patient. The rupture of the appendix of the cecum leads to abscesses of the abdominal cavity, peritonitis, sepsis, which are extremely dangerous for the health of the child. With hemorrhagic or purulent form of pancreatitis, there is also a high risk of death. Very dangerous and such diseases as meningitis and encephalitis, the prognosis of recovery depends on the speed of the begun therapy.

[38], [39], [40]