Effective Hydration-Centered Management of Acute Gastroenteritis in a 13-Year-Old Patient: Insights from Primary Care Practice
DOI:
https://doi.org/10.58524/brtl.v1i2.74Keywords:
acute gastroenteritis, dehydration management, pediatric case, holistic assessment, rehydration therapy, primary careAbstract
Acute gastroenteritis remains one of the most common acute conditions in children and adolescents, frequently leading to dehydration and requiring prompt clinical assessment to prevent further complications. Although management guidelines are well established, variability in presentation and progression highlights the importance of individualized and holistic diagnostic approaches in primary care. This report describes a case involving a 13-year-old male who presented with severe gastrointestinal symptoms, including diarrhea exceeding ten episodes per day over three consecutive days, more than five episodes of vomiting, abdominal pain, fever, and generalized weakness. Clinical examination demonstrated a weakened overall condition, blood pressure of 100/70 mmHg, pulse 85 beats per minute, respiratory rate 20 breaths per minute, temperature 36.7°C, and signs consistent with mild to moderate dehydration. Laboratory evaluation revealed slightly decreased leukocyte levels, suggesting a likely viral etiology. The management in this case reflects the methodological core of the intervention: a holistic, stepwise approach integrating intravenous rehydration, symptomatic therapy, and adaptive pharmaceutical adjustments based on evolving clinical features. The patient was administered Ringer’s Lactate intravenously through a loading dose followed by controlled infusion at 25 drops per minute. Antiemetic therapy with ondansetron, antipyretics, antacids, attapulgite, and oral rehydration solution were provided initially. On the second day, antibiotics and ranitidine were introduced in response to persistent gastrointestinal complaints and to prevent potential secondary complications. The results demonstrated clear clinical improvement within 72 hours, marked by decreased diarrhea frequency, cessation of vomiting, and normalization of vital signs (blood pressure 100/65 mmHg; pulse 80 beats per minute). Hydration status returned to normal, and no complications or referral indications were identified. This case underscores the conclusion that integrating holistic assessment with tailored rehydration strategies and selective pharmacologic therapy can produce rapid and effective recovery in pediatric acute gastroenteritis. The novelty lies in demonstrating how a dynamic, symptom-guided model of care in a primary health setting can optimize outcomes while minimizing unnecessary escalation of treatment.
References
Efunshile, A. M., Ezeanosike, O., Nwangwu, C. C., König, B., Jokelainen, P., & Robertson, L. J. (2019). Apparent overuse of antibiotics in the management of watery diarrhoea in children in Abakaliki, Nigeria. BMC Infectious Diseases, 19(1), 275. https://doi.org/10.1186/s12879-019-3880-4
Farthing, M., Salam, M. A., Lindberg, G., Dite, P., Khalif, I., Salazar-Lindo, E., Goh, K. (2013). Acute diarrhea in adults and children: A global perspective. Journal of Clinical Gastroenterology, 47(1), 12–20. https://doi.org/10.1097/MCG.0b013e31826df662
Fischer Walker, C. L., Perin, J., Aryee, M. J., Boschi-Pinto, C., & Black, R. E. (2012). Diarrhea incidence in low- and middle-income countries: A systematic review and meta-analysis. PLOS ONE, 7(12), e52779. https://doi.org/10.1371/journal.pone.0052779
Freedman, S. B., Ali, S., Oleszczuk, M., Gouin, S., & Hartling, L. (2015). Treatment of acute gastroenteritis in children: An overview of systematic reviews of interventions. PLOS ONE, 10(6), e0127508. https://doi.org/10.1371/journal.pone.0127508
Freedman, S. B., Powell, E. C., Nava-Ocampo, A., & Finkelstein, Y. (2011). Oral ondansetron for gastroenteritis in a pediatric emergency department. New England Journal of Medicine, 354(16), 1698–1705. https://doi.org/10.1056/NEJMoa055119
Fugetto, F., Filice, E., Biagi, C., Pierantoni, L., Gori, D., & Lanari, M. (2020). Single-dose ondansetron for vomiting in children and adolescents with acute gastroenteritis: An updated systematic review and meta-analysis. European Journal of Pediatrics, 179(7), 1007–1016. https://doi.org/10.1007/s00431-020-03607-3
Gagnier, J. J., Kienle, G., Altman, D. G., Moher, D., Sox, H., & Riley, D. (2013). The CARE guidelines: Consensus-based clinical case reporting guideline development. BMJ Case Reports, 2013, bcr2013201554. https://doi.org/10.1136/bcr-2013-201554
Guarino, A., Ashkenazi, S., Gendrel, D., Lo Vecchio, A., Shamir, R., & Szajewska, H. (2018). European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases guidelines for acute gastroenteritis in children. Journal of Pediatric Gastroenterology and Nutrition, 67(5), 586–593. https://doi.org/10.1097/MPG.0000000000002055
Guarino, A., Lo Vecchio, A., Dias, J. A., Berkley, J. A., Boey, C., Bruzzese, D., Salazar-Lindo, E. (2018). Universal recommendations for the management of acute diarrhea in nonmalnourished children. Journal of Pediatric Gastroenterology and Nutrition, 67(5), 586–593. https://doi.org/10.1097/MPG.0000000000002053
Hartling, L., Bellemare, S., Wiebe, N., Russell, K. F., Klassen, T. P., & Craig, W. (2006). Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Cochrane Database of Systematic Reviews, (3), CD004390. https://doi.org/10.1002/14651858.CD004390
Kusmayanti, E., & Sibualamu, K. Z. (2023). Fluid management in children with diarrhea: A scoping review. Scientific Journal of Health Diagnosis, 18(2), 64–72.
Lanata, C. F., Fischer-Walker, C. L., Olascoaga, A. C., Torres, C. X., Aryee, M. J., & Black, R. E. (2013). Child mortality due to diarrhea in developing countries. Seminars in Pediatric Infectious Diseases, 21(3), 189–193. https://doi.org/10.1053/j.spid.2010.10.007
Leonard Sumadi Jap, A. (2021). Acute diarrhea in children caused by infection in children. Journal of Clinical Medicine, 27(3), 282–288.
López, L. M., Cerezo, S., Camarero, C., & Sebastián, M. (2019). Dehydration assessment in children: Clinical evaluation versus point-of-care ultrasound. Pediatric Emergency Care, 35(3), 180–185. https://doi.org/10.1097/PEC.0000000000001391
MacDonald, E., & McCormack, S. (2020). Ondansetron and oral rehydration therapy in pediatric patients with dehydration: A review of clinical effectiveness. Canadian Agency for Drugs and Technologies in Health.
Munos, M. K., Walker, C. L., & Black, R. E. (2010). The effect of oral rehydration solution and recommended home fluids on diarrhea mortality. International Journal of Epidemiology, 39(Suppl 1), i75–i87. https://doi.org/10.1093/ije/dyq027
National Collaborating Centre for Women’s and Children’s Health (UK). (2009). Diarrhoea and vomiting caused by gastroenteritis: Diagnosis, assessment and management in children younger than 5 years. National Institute for Health and Clinical Excellence (NICE).
Nino-Serna, L. F., Acosta-Reyes, J., Veroniki, A.-A., & Florez, I. D. (2020). Antiemetics in children with acute gastroenteritis: A meta-analysis. Pediatrics, 145(4), e20193260. https://doi.org/10.1542/peds.2019-3260
Porter, C. K., Riddle, M. S., & Tribble, D. R. (2020). Acute infectious diarrhea in children and adults: A global overview. Current Opinion in Infectious Diseases, 33(5), 375–383. https://doi.org/10.1097/QCO.0000000000000672
Subagya, A. N., Zukra, R. M., & Hasanah, L. N. (2020). Management of gastroenteritis in children: A literature review. Jurnal Kesehatan, 4(3), 150–156. https://jurnal.ugm.ac.id/jkkk/article/view/84349
Tomasik, E., Ziółkowska, E., Kołodziej, M., & Szajewska, H. (2016). Ondansetron for vomiting in children with acute gastroenteritis: A systematic review and meta-analysis. Alimentary Pharmacology & Therapeutics, 44(5), 438–446. https://doi.org/10.1111/apt.13726
UK, National Collaborating Centre for Women’s and Children’s Health. (2009). Diarrhoea and vomiting caused by gastroenterenteritis: Diagnosis, assessment and management in children younger than 5 years. London: National Institute for Health and Clinical Excellence (NICE). https://www.nice.org.uk/guidance/cg84
World Health Organization. (2005). The treatment of diarrhoea: A manual for physicians and other senior health workers (4th rev.). WHO Press.
World Health Organization. (2024). Diarrhoeal disease: Key facts. Retrieved from https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Nia Triswanti, Dian Vitria, Syalwa Lutfhi Rahmadini, Shafa Annisa Rembulan E. K, Shevani Adelia, Silviatara Putri Maharani, Siti Aisyah, Siti Rahayu (Author)

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.