[Infectious diarrhea in young children and infants]

Acute diarrhoea is one of the major causes of outpatient paediatric consultation, especially during infancy. An infectious cause should be suspected on the acute onset of diarrhoea associated with fever. The specific pathogen is seldom investigated and individualized. Rotavirus has been recognized as the most important enteric pathogen, particularly in infants during winter months. It may be responsible for nosocomial infections in hospital and outbreaks in day-care centers. Bacteria may cause a diarrhoea by elaboration of enterotoxins, by invasiveness, or both. Use of antibiotic is usually not necessary even in bacterial infections because they are self-limited. Choice of the antibiotic is complicated by the rapid emergence of resistant pathogenic strains. The first step is rapid assessment of the hydratation status of the patient. Fluid and electrolytes replacement is the mainstay in the treatment of infectious diarrhoea of any cause.