Approach to diarrhea (pediatrics) Quiz: Ace Your Exams
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A 4-year-old boy presents to the emergency department for evaluation of diarrhea and abdominal pain. He is accompanied by a parent who reports the child has had symptoms for three days, with 5-10 episodes of diarrhea per day. He vomited twice on the first day of symptoms but has had no vomiting since and has maintained good oral intake. Bright red blood was seen in the stool this morning. His abdominal pain is crampy and intermittent. The parent reports they were at an outdoor family picnic this past weekend where slightly undercooked hamburgers were served. They have not travelled recently and only drink bottled water. The patient does not have chronic medical conditions and was in good health prior to symptom onset. Family history includes Crohn’s disease in his paternal uncle. The patient has been growing well and keeping on his growth curve. Temperature is 38.5°C (101.3°F), pulse is 120/min, respiratory rate is 26/min, and blood pressure is 100/58 mmHg. On examination, the child is awake and in no acute distress. Mucus membranes are slightly dry. Abdominal examination reveals mild diffuse tenderness to palpation without guarding or rebound tenderness. Complete blood count and comprehensive metabolic panel are within normal limits. Which of the following is the best next step in the diagnostic workup?
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