Patient selection: pediatric patient (< 5 years for the guideline, but findings should apply to older pediatric patients as well) with vomiting and/or diarrhea
Findings suggesting a diagnosis other than viral gastroenteritis:
(1) fever (>= 38°C if an infant < 3 months old; >= 39° if >= 3 months old)
(2) tachypnea and/or shortness of breath
(3) decreased level of consciousness
(4) neck stiffness
(5) severe or localized abdominal pain
(6) abdominal distention
(7) rebound tenderness over the abdomen
(8) non-blanching rash
(9) bulging fontanelle in an infant
(10) bile-colored vomit
(11) stool with blood, mucus and/or white blood cells
Historical findings which should prompt a careful evaluation of the patient:
(1) past history of bowel obstruction
(2) past history of abdominal surgery
(3) immunocompromised status
