A 3-year-old female patient presented with severe abdominal pain that had been recurring for 8 days.
She had already visited the paediatric emergency department twice in the previous 4 days. A urine test and an abdominal ultrasound were unremarkable. Suspecting constipation, the patient was sent home with a laxative (Macrogol) and painkillers. Two weeks before the current episode, the patient had diarrhoea and fever for 2 days.
The patient suffered from abdominal pain, especially at night. She woke up 2–3 times per night with severe pain and, according to her parents, a hard abdomen. Painkillers such as ibuprofen and paracetamol brought no improvement. There was no fever, vomiting or diarrhoea at that time. Eating and drinking behaviour was normal. The girl was fully immunised according to German recommendations.
The physical examination revealed an active and cheerful child, with no significant findings. The abdomen was soft on palpation, with increased bowel sounds.
An ultrasound scan showed bowel loops filled with faeces and fluid, as well as a small amount of free fluid.
Gastroenteritis, i.e. a gastrointestinal infection, was suspected. The patient was evaluated within the paediatrics department in Marbella. A PCR stool test was performed and returned positive for rotavirus, confirming the diagnosis.
Rotaviruses are transmitted via various routes:
- contaminated water and food
- faecal-oral transmission
- droplet infection
These viruses are highly resistant and can survive on surfaces for days. Even a small number of pathogens can trigger infection.
The disease is most common in Europe between February and April and primarily affects infants and young children.
The incubation period is 1–3 days. The infection may be mild or severe, potentially causing diarrhoea, fever and abdominal pain.
In infants and young children, rotavirus infections tend to be more severe, often with sudden watery diarrhoea, vomiting and risk of rapid dehydration.
Due to fluid loss, hospitalisation may be required to ensure proper hydration, often coordinated through family medicine or paediatric care.
In developed countries, severe complications are rare, although hospitalisation is still common in young children.
Diagnosis is confirmed by detecting the virus in stool samples. There is no specific causal treatment, and management focuses on hydration.
Vaccination against rotavirus is available and significantly reduces severe cases.
While mild side effects may occur, vaccination is considered safe. The risk of complications such as intussusception is low and actually higher in natural infections.
In cases of persistent digestive symptoms or diagnostic uncertainty, further evaluation by specialists in gastroenterology may be required.
The patient recovered completely.
Dr. Med. Laura Schrörs – Adolescent Medicine and Paediatrics
