Rotavirus gastroenteritis according to ICD 10. Viral intestinal infections in children. Epidemiology of rotavirus infection

In medical practice, when making a diagnosis, special codes are always used, according to ICD-10.

An entire section of the classifier is devoted to a disease such as herpes.

Herpes and the classification system

Herpes is a very common infectious disease that affects a large part of the population. Carriers of the virus may not even suspect that they are sick, since the disease may not manifest itself for a very long time, sometimes even a lifetime. At the same time, herpes has a high degree of contagiousness, which, given the most common routes of transmission (airborne droplets and household contact), leads to the rapid spread of infection from the sick person to healthy people. The disease can manifest itself in the event of a sharp weakening of the immune system. As a rule, this occurs in the form of various kinds of rashes on the skin and mucous membranes. The “cold” on the lips, familiar to many, is a classic manifestation of a herpetic infection.

As you know, the cause of herpes is a specific virus, but there are quite a few types of these microorganisms, and therefore the disease itself is divided into several types, depending on the pathogen. So, for example, the above-mentioned “cold” is caused by a virus of the 1st simple type. Herpes type 4 leads to infectious mononucleosis, type 5 is known as cytomegalovirus. In total, there are 7 similar types, and the diseases caused by them have been well studied and are also reflected in the ICD 10 revision.

The International Classification of Diseases is a special document developed and adopted by the World Health Organization. It contains a list of various diseases and is used for statistical and classification purposes.

The classification system itself appeared quite a long time ago, at the end of the 19th century, and, as medicine developed, it was subject to periodic revisions, additions and clarifications, called revision. The last of them, the tenth, occurred in 1989. Then, at a WHO meeting held in Geneva, Switzerland, the updated ICD, 10th revision, was adopted.

Each disease or injury has its own specific code in accordance with this classifier. It is understandable to every medical specialist. Thus, the main task of ICD 10 is the standardization and unification of scattered medical data on the names of certain ailments.

In addition, recording a disease in the form of a special code unique to it provides convenience in analyzing and storing data, which is necessary for statistical recording.

In more global issues related to the management of the healthcare system on a national or even global scale, the classifier is used to analyze epidemiological data, information on the prevalence of certain diseases by age, gender and other categories, etc.

Infections caused by HSV

The herpes simplex virus, belonging to types 1 and 2, which leads to the well-known “cold,” under a number of unfavorable conditions can cause a number of serious diseases that affect not only the skin and mucous membranes, but also, for example, the central nervous system, which leads to quite severe consequences for the body.

In ICD-10, infections caused by HSV have a common code B00.

Let's look at each disease in more detail in accordance with the classifier.

This code refers to herpetic eczema, which is a complication of herpes. It manifests itself in the form of swelling and redness of the skin, rash in the head, neck, and upper torso. Subsequently, blisters and ulcers form at the site of the skin rash.

The disease is acute, with characteristic signs of general intoxication of the body: elevated body temperature, weakness, enlarged regional lymph nodes. With proper treatment, recovery occurs in about 2 weeks.

This is herpetic vesicular dermatitis, characterized by the periodic appearance of rashes affecting the skin and mucous membranes. It has a characteristic relapsing course.

Diseases affecting the oral mucosa are herpetic gingostomatitis and pharyngostomatitis. They appear in the form of characteristic rashes that affect the gums and palate.

Herpetic viral meningitis is an extremely dangerous disease that affects the meninges. As a rule, small children or people with weakened immune systems get sick. All the signs of ordinary viral meningitis are characteristic, such as:

If the course is unfavorable, cerebral edema may occur - a severe condition, often leading to death.

Encephalitis caused by the herpes simplex virus. It is also characterized by damage to the brain and central nervous system as a whole. Among the symptoms of the disease, neurological disorders (convulsions, aphasia, confusion, hallucinations) and phenomena characteristic of general intoxication of the body prevail. Also, if not treated in a timely manner, death can occur.

This code refers to eye lesions caused by the herpes simplex virus. The following symptoms are characteristic:

redness of the cornea, eyelids;

lacrimation;

discharge of purulent contents;

impaired visual acuity and color perception;

itching, pain and other unpleasant symptoms.

This includes conjunctivitis, keratitis, eyelid dermatitis and others.

This code indicates sepsis (blood poisoning) caused by herpes infection

This code should be understood as all other infections caused by the simple herpes virus and accompanied by the appearance of rashes, itching and discomfort on the skin and mucous membranes. In addition, this includes hepatitis, that is, viral damage to the liver.

This code encrypts those diseases and conditions that are caused by herpes, but do not have their own place in the classifier due to their extremely low prevalence and lack of knowledge.

Infections caused by herpes type 3

The third type of herpes causes two common diseases - chickenpox and shingles.

This code marks the familiar chickenpox, which most people suffered from in childhood. This disease is characterized by the appearance of itchy blisters throughout the body with the formation of blisters filled with fluid. The disease is also characterized by signs of intoxication of the body in the form of fever and general weakness.

Chickenpox usually resolves without complications, as defined by code B01.9. however, in some cases, severe accompanying symptoms are possible, which are reflected in the classifier.

Thus, the code B.01.0 denotes chickenpox complicated by meningitis, B.01.1 with encephalitis, B.01.2 with pneumonia.

This code denotes lichen, a disease that affects the skin mainly on the patient’s torso.

This code, similar to the chickenpox code, has subcategories associated with complications of this disease.

Many people think that herpes is a harmless disease, manifested only by periodic blisters on the lips. As can be seen from ICD-10, this is erroneous, because under unfavorable conditions this virus can cause many diseases of varying severity, including deadly ones.

Features of felon according to ICD-10

Panaritium is an infection of the soft tissues in the area of the fingertip, having ICD-10 code L03.0. The peculiarity of felon is that it develops in separate cellular spaces of the finger. They are separated by connective tissue septa, within which infection can occur.

With minor finger injuries, the infection begins to develop in individual tissue cells. The appearance of edema and pus in a closed volume sharply increases blood pressure. Because of this, the blood supply to the infected area is disrupted, and local foci of necrosis quickly develop.

Sometimes the area of necrosis spreads to the skin and spontaneous decompression of the inflammatory focus occurs. If the skin remains intact, the infection will spread to other parts of the finger and hand. Most often, felon develops in the thumb and index finger.

As the infection progresses, acute pain appears in the finger, which is associated with swelling of a separate cell of the cellular space. At this stage, felon may resolve without treatment.

As felon progresses, throbbing pain appears, which interferes with sleep. The first sleepless night is an indication for surgical treatment of felon.

One of the variants of felon may be paronychia, which affects the periungual fold.

Paronychia is the most common hand infection that begins as an inflammation of the subcutaneous tissue but can quickly develop into an abscess. This disease occurs three times more often in women than in men. Patients with HIV infection and people taking glucocorticoids for a long time are predisposed to its development.

Some diseases damage the nail plate, periungual fold, cuticles and provoke the development of paronychia. These include:

psoriasis;

side effects of retinoids;

drugs for the treatment of HIV infection.

There are two types of paronychia:

Acute - a painful condition accompanied by the formation of pus caused by staphylococcus.
Chronic – it is caused by a fungal infection.

Acute paronychia usually develops as a result of a minor injury that separates the periungual fold from the nail. Such damage includes:

Acute paronychia is characterized by the following symptoms:

swelling and redness of the fingertip;
accumulation of pus under the skin;
inflammation of the skin fold at the base of the nail.

The area of inflammation and accumulation of pus may spread to the opposite nail fold through the skin at the base of the nail plate. Paronychia can develop into panaritium. As the infection progresses, damage to deep structures, tendons, bones and joints is possible.

Chronic paronychia

The cause of chronic paronychia is a fungal infection. If this disease does not respond to treatment for a long time, then it may be a manifestation of some kind of neoplasm.

This disease develops in people who work in a damp environment or come into contact with weak alkalis or acids. This category includes:

Chronic paronychia manifests itself:

swelling, redness and soreness of the periungual ridges without signs of liquid pus;
thickening and change in color of the nail plate, the appearance of pronounced transverse grooves on it;
separation of the cuticle and ridges from the nail plate, which may predispose to infection.

To diagnose paronychia and felon, various microbiological techniques are used that can identify bacteria, fungi or signs of herpetic infection.

X-rays are sometimes used to identify a foreign body inside the finger.

Treatment of paronychia and panaritium

If redness of the skin around the nail appears, you should take baths consisting of 50% hot water and liquid antibacterial soap 3-4 times a day for 15 minutes.

If visible accumulations of pus appear against the background of reddened skin, you should consult a doctor. You will also need to consult a surgeon if swelling and redness of the skin spreads from the area of the periungual ridges to the area of the fingertip.

When any abscess forms, it must be opened and drained. Sometimes it becomes necessary to completely remove the nail plate. After draining the abscesses, the patient should also take hot baths for 48 hours.

If the redness of the skin does not extend beyond the boundaries of the periungual ridges, then there is no need for antibacterial drugs. However, if severe soft tissue swelling occurs in a patient with diabetes, peripheral vascular disease, or immunodeficiency, a short course of antibiotics will be needed.

Antibacterial agents for paronychia are prescribed to patients with chronic diseases or in cases where swelling and redness spread to the fingertip.

The most common cause is the bacterium Staphylococcus. This microorganism is not sensitive to regular penicillin. Therefore, protected penicillins or first-generation cephalosporins are used for treatment.

Most cases of paronychia can be treated at home. Hospitalization may be necessary when the infection spreads to the deep tissue spaces of the arm, tendon, or bone. Chronic paronychia is treated with topical or oral antifungal drugs.

To prevent felon you should:

Give up the habit of biting your nails.
Wear rubber gloves when washing hands frequently or working in wet environments.
Control chronic diseases such as diabetes.
Wash your hands frequently when working with soil, wood, or in any situation where you might get a cut, puncture, or abrasion.

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Rotavirus infection

Rotavirus infection (rotavirus gastroenteritis) is an acute infectious disease caused by rotaviruses, characterized by symptoms of general intoxication and damage to the gastrointestinal tract with the development of gastroenteritis.

A08.0. Rotavirus enteritis.

Etiology (causes) of rotavirus infection

The causative agent is a member of the family Reoviridae, genus Rotavirus (rotavirus). The name is based on the morphological similarity of rotaviruses to a wheel (from the Latin “rota” - “wheel”). Under an electron microscope, viral particles look like wheels with a wide hub, short spokes and a clearly defined thin rim. The rotavirus virion with a diameter of 65–75 nm consists of an electron-dense center (core) and two peptide shells: an outer and an inner capsid. The core, 38–40 nm in diameter, contains internal proteins and genetic material represented by double-stranded RNA. The genome of human and animal rotaviruses consists of 11 fragments, which probably determines the antigenic diversity of rotaviruses. Replication of rotaviruses in the human body occurs exclusively in the epithelial cells of the small intestine.

Rotavirus infection, view through an electron microscope

Four main antigens have been found in rotaviruses; the main one is the group antigen - the protein of the internal capsid. Taking into account all group-specific antigens, rotaviruses are divided into seven groups: A, B, C, D, E, F, G. Most human and animal rotaviruses belong to group A, within which subgroups (I and II) and serotypes are distinguished. Subgroup II includes up to 70–80% of strains isolated from patients. There is evidence of a possible correlation between certain serotypes and the severity of diarrhea.

Rotaviruses are resistant to environmental factors: in drinking water, open reservoirs and wastewater they persist for up to several months, on vegetables for 25–30 days, on cotton and wool for up to 15–45 days. Rotaviruses are not destroyed by repeated freezing, under the influence of disinfectant solutions, ether, chloroform, ultrasound, but they die when boiled, treated with solutions with a pH of more than 10 or less than 2. Optimal conditions for the existence of viruses: temperature 4 ° C and high (>90%) or low (<13%) влажность. Инфекционная активность возрастает при добавлении протеолитических ферментов (например, трипсина, панкреатина).

Epidemiology of rotavirus infection

The main source of infection and reservoir of rotavirus infection- a sick person who excretes a significant amount of viral particles with feces (up to 1010 CFU per 1 g) at the end of the incubation period and in the first days of the disease. After the 4th–5th day of illness, the amount of virus in the feces decreases significantly, but the total duration of rotavirus isolation is 2–3 weeks. Patients with impaired immunological reactivity, chronic concomitant pathology, and lactase deficiency secrete viral particles for a long time.

Source of pathogen infections can also be caused by healthy virus carriers (children from organized groups and hospitals, adults: primarily medical staff of maternity hospitals, somatic and infectious diseases departments), from whose feces rotavirus can be isolated for several months.

The mechanism of transmission of the pathogen is fecal-oral. Transmission routes:

— contact household (through dirty hands and household items);

- water (when drinking water infected with viruses, including bottled water);

— nutritional (most often when consuming milk and dairy products).

The possibility of airborne transmission of rotavirus infection cannot be ruled out.

Rotavirus infection is highly contagious, as evidenced by the rapid spread of the disease among patients. During outbreaks, up to 70% of the non-immune population becomes ill. During a seroepidemiological study, antibodies to various rotaviruses are detected in the blood of 90% of children of older age groups.

After an infection, in most cases, short-term type-specific immunity is formed. Recurrent diseases are possible, especially in older age groups.

Rotavirus infection is ubiquitous and is detected in all age groups. In the structure of acute intestinal infections, the share of rotavirus gastroenteritis ranges from 9 to 73%, depending on age, region, standard of living and season. Children in the first years of life (mainly from 6 months to 2 years) get sick especially often. Rotaviruses are one of the causes of diarrhea accompanied by severe dehydration in children under 3 years of age; this infection is responsible for up to 30–50% of all cases of diarrhea requiring hospitalization or intensive rehydration. According to WHO, from 1 to 3 million children die from this disease every year in the world. Rotavirus infection accounts for about 25% of cases of so-called traveler's diarrhea. In Russia, the frequency of rotavirus gastroenteritis in the structure of other acute intestinal infections ranges from 7 to 35%, and among children under 3 years of age it exceeds 60%.

Rotaviruses are one of the most common causes of nosocomial infections, especially among premature newborns and young children. In the structure of nosocomial acute intestinal infections, rotaviruses account for from 9 to 49%. Nosocomial infection is facilitated by children's long stay in the hospital. Medical personnel play a significant role in the transmission of rotaviruses: in 20% of employees, even in the absence of intestinal disorders, IgM antibodies to rotavirus are detected in the blood serum, and rotavirus antigen is detected in coprofiltrates.

In areas with temperate climates, rotavirus infection is seasonal, prevailing in the cold winter months, which is associated with better survival of the virus in the environment at low temperatures. In tropical countries, the disease occurs all year round, with a slight increase in incidence during the cool, rainy season.

Prevention of rotavirus infection includes a set of anti-epidemic measures taken against the entire group of acute intestinal infections with the fecal-oral mechanism of infection. This is, first of all, rational nutrition, strict adherence to sanitary standards of water supply and sewerage, and increasing the level of sanitary and hygienic education of the population.

For the specific prevention of rotavirus infection in humans, the use of several vaccines is proposed, currently undergoing the final phases of clinical trials regarding effectiveness and safety. These are the Rotarix vaccine (GlaxoSmithKline), based on the human type of virus, and a vaccine based on human and cow strains of rotavirus, created in the laboratory of Merck & Co.

The pathogenesis of rotavirus infection is complex. On the one hand, great importance in the development of rotavirus gastroenteritis is attached to the structural (VP3, VP4, VP6, VP7) and non-structural (NSP1, NSP2, NSP3, NSP4, NSP5) proteins of the virus. In particular, NSP4 peptide is an enterotoxin that causes secretory diarrhea, like bacterial toxins; NSP3 influences viral replication, and NSP1 can inhibit the production of interferon regulatory factor 3.

On the other hand, already on the first day of the disease, rotavirus is detected in the epithelium of the mucous membrane of the duodenum and the upper parts of the jejunum, where it multiplies and accumulates. Penetration of rotavirus into a cell is a multi-stage process. To enter the cell, some rotavirus serotypes require specific receptors containing sialic acid. The important role of proteins has been established: α2β1-integrin, βVβ3 integrin and hsc70 in the initial stages of interaction between the virus and the cell, while the entire process is controlled by the viral protein VP4. Having penetrated into the cell, rotaviruses cause the death of mature epithelial cells of the small intestine and their rejection from the villi. The cells that replace the villous epithelium are functionally defective and are not able to adequately absorb carbohydrates and simple sugars.

The occurrence of disaccharidase (mainly lactase) deficiency leads to the accumulation in the intestine of undigested disaccharides with high osmotic activity, which causes impaired reabsorption of water and electrolytes and the development of watery diarrhea, often leading to dehydration. Entering the large intestine, these substances become substrates for fermentation by intestinal microflora with the formation of large amounts of organic acids, carbon dioxide, methane and water. The intracellular metabolism of cyclic adenosine monophosphate and guanosine monophosphate in epithelial cells remains virtually unchanged during this infection.

Thus, at present, two main components are distinguished in the development of diarrhea syndrome: osmotic and secretory.

Clinical picture (symptoms) of rotavirus infection

The incubation period ranges from 14–16 hours to 7 days (on average 1–4 days).

There are typical and atypical rotavirus infections. A typical rotavirus infection, depending on the severity of the leading syndromes, is divided into mild, moderate and severe forms. Atypical forms include erased (clinical manifestations are weak and short-lived) and asymptomatic forms (complete absence of clinical manifestations, but rotavirus and a specific immune response are detected in the laboratory). The diagnosis of virus carriage is established when rotavirus is detected in a healthy person who did not have any changes in specific immunity during the examination.

The disease most often begins acutely, with an increase in body temperature, the appearance of symptoms of intoxication, diarrhea and repeated vomiting, which allowed foreign researchers to characterize rotavirus infection as DFV syndrome (diarrhea, fever, vomiting). These symptoms are observed in 90% of patients; they occur almost simultaneously on the first day of illness, reaching maximum severity within 12–24 hours. In 10% of cases, vomiting and diarrhea appear on the 2–3rd day of illness.

A gradual onset of the disease is also possible, with a slow increase in the severity of the process and the development of dehydration, which often leads to late hospitalization.

Vomiting is not only one of the first, but often the leading sign of rotavirus infection. It usually precedes diarrhea or appears simultaneously with it, can be repeated (up to 2–6 times) or multiple times (up to 10–12 times or more), and lasts for 1–3 days.

The increase in body temperature is moderate: from subfebrile to febrile values. The duration of fever ranges from 2–4 days; fever is often accompanied by symptoms of intoxication (lethargy, weakness, loss of appetite, even anorexia).

Intestinal dysfunction occurs predominantly as gastroenteritis or enteritis, characterized by liquid, watery, foamy yellow stool without pathological impurities. The frequency of bowel movements often corresponds to the severity of the disease. With copious loose stools, dehydration may develop, usually grades I–II. Only in isolated cases is severe dehydration with decompensated metabolic acidosis observed, and acute renal failure and hemodynamic disorders are possible.

From the very beginning of the disease, abdominal pain may be observed. More often they are moderate, constant, localized in the upper half of the abdomen; in some cases - cramping, strong. On palpation of the abdomen, pain is noted in the epigastric and umbilical regions, and rough rumbling in the right iliac region. The liver and spleen are not enlarged. Signs of damage to the digestive organs persist for 3–6 days.

Some patients, mainly young children, develop catarrhal symptoms: coughing, runny nose or nasal congestion, rarely - conjunctivitis, catarrhal otitis media. Upon examination, attention is drawn to hyperemia and granularity of the soft palate, palatine arches, and uvula.

The amount of urine in the acute period of the disease is reduced, some patients experience slight proteinuria, leukocyturia, erythrocyturia, as well as an increase in creatinine and urea in the blood serum. At the beginning of the disease there may be leukocytosis with neutrophilia, during the peak period it is replaced by leukopenia with lymphocytosis; ESR is not changed. A coprocytogram is characterized by the absence of signs of a pronounced inflammatory process; at the same time, starch grains, undigested fiber, and neutral fat are detected.

Most patients with rotavirus infection experience a disturbance in the composition of the fecal microflora, primarily a decrease in the content of bifidobacteria, as well as an increase in the number of opportunistic microbial associations. Look for signs of lactase deficiency, including acidic stool pH values.

Symptoms characteristic of mild forms of rotavirus infection:

- low-grade body temperature;

— moderate intoxication for 1–2 days;

- loose stool up to 5-10 times a day.

In moderate forms of the disease the following is noted:

- severe intoxication (weakness, lethargy, headache, pale skin);

- repeated vomiting within 1.5–2 days;

- copious watery stools from 10 to 20 times a day;

— dehydration of I–II degree.

Severe forms of rotavirus gastroenteritis are characterized by a rapid onset with an increase in the severity of the condition by the 2nd–4th day of the disease due to significant fluid losses (dehydration of II–III degree), repeated vomiting and numerous watery stools (more than 20 times a day). Hemodynamic disturbances are possible.

Complications of rotavirus infection:

— acute cardiovascular failure;

- acute extrarenal renal failure;

- secondary disaccharidase deficiency;

It is necessary to take into account the possibility of secondary bacterial infection, which leads to changes in the clinical picture of the disease and requires correction of the therapeutic approach. Due to the possibility of developing complications with rotavirus gastroenteritis, high-risk groups of patients are identified, which include newborns, young children, elderly people, as well as patients with severe concomitant diseases. The features of the course of rotavirus infection in people with immunodeficiencies (for example, HIV-infected people), who may experience necrotizing enterocolitis and hemorrhagic gastroenteritis, have not been sufficiently studied.

Lethal outcomes are more common in young children with severe immunological deficiency and malnutrition, as well as among elderly patients with severe concomitant pathologies (such as atherosclerosis, chronic hepatitis), in some cases with mixed infection.

Diagnosis of rotavirus infection

The main clinical and diagnostic signs of rotavirus infection:

* characteristic epidemiological history - group nature of the disease in the winter season;

* acute onset of the disease;

* increased body temperature and intoxication syndrome;

* vomiting as a leading symptom;

* moderate abdominal pain;

For laboratory confirmation of the rotavirus nature of the disease, three groups of methods are used:

* methods based on the detection of rotavirus and its antigens in feces:

– electron and immunoelectron microscopy;

* methods for detecting viral RNA in coprofiltrates:

– molecular probe method - PCR and hybridization;

– RNA electrophoresis in polyacrylamide gel or agarose;

* methods for detecting specific antibodies (immunoglobulins of various classes and/or an increase in antibody titer) to rotaviruses in blood serum (ELISA, RSK, RTGA, RNGA).

In practice, the diagnosis of rotavirus infection is most often based on the detection of viral antigen in coprofiltrates using RLA, ELISA on days 1–4 of the disease.

Differential diagnosis

Rotavirus infection is differentiated from cholera, dysentery, escherichiosis, gastrointestinal forms of salmonellosis, and intestinal yersiniosis (Table 18-22).

Indications for consultation with other specialists

An example of a diagnosis formulation

A08.0 Rotavirus infection, gastroenteritis syndrome, moderate form, degree I dehydration.

Treatment of rotavirus infection

Patients with moderate and severe forms of rotavirus infection, as well as patients posing a high epidemiological danger (decreed contingents), are subject to hospitalization.

Complex treatment of rotavirus infection includes nutritional therapy, etiotropic, pathogenetic and symptomatic therapy.

Milk and dairy products are excluded from the diet, and carbohydrate intake is limited (vegetables, fruits and juices, legumes). Food should be physiologically complete, mechanically and chemically gentle, with sufficient protein, fat, mineral salts and vitamins. It is necessary to increase the frequency of meals.

One of the promising methods for treating rotavirus infection is the use of drugs with antiviral and interferon activity, in particular, meglumine acridone acetate (cycloferon). Meglumine acridone acetate in tablet form is taken on days 1–2–4–6–8 in the age-appropriate dosage: up to 3 years - 150 mg; 4–7 years - 300 mg; 8–12 years - 450 g; adults - 600 mg once. The use of meglumine acridone acetate leads to more effective elimination of rotavirus and a reduction in the duration of the disease.

In addition, immunoglobulins for enteral administration can be used as therapeutic agents: normal human immunoglobulin (IgG+IgA+IgM) - 1–2 doses 2 times a day. Antibacterial agents are not indicated.

Pathogenetic treatment aimed at combating dehydration and intoxication is carried out by administering polyionic crystalloid solutions, intravenously or orally, taking into account the degree of dehydration and the patient’s body weight.

Oral rehydration is carried out with solutions heated to 37–40 °C: glucosolan, citraglucosolan, rehydron. For infusion therapy, polyionic solutions are used.

An effective method for treating diarrhea of rotavirus etiology is enterosorption: dioctahedral smectite, 1 powder 3 times a day; polymethylsiloxane polyhydrate, 1 tablespoon 3 times a day; hydrolytic lignin, 2 tablets 3-4 times a day.

Considering enzymatic deficiency, it is recommended to use multienzyme agents (such as pancreatin) 1-2 tablets 3 times a day with meals.

In addition, when treating rotavirus infection, it is advisable to include biological products containing bifidobacteria (bifiform 2 capsules 2 times a day).

Table 18-22. Main differential diagnostic signs of acute intestinal infections

What is the ICD 10 code for lacunar tonsillitis and how does the disease manifest?

Having its own code according to ICD 10, lacunar tonsillitis is an extreme form of inflammation of the palatine tonsils, located in the recess of the mouth between the upper palate and the tongue. The name of the disease comes from the word “lacuna”, meaning a small depression with ducts. Pathogenic microbes accumulate in the gaps, forming a yellowish-white coating and causing inflammation.

Lacunar tonsillitis is the most severe form of acute tonsillitis. The word tonsillitis comes from the Latin "tonsils". The more common and familiar name for this disease is tonsillitis. The International Classification of Diseases, 10th revision (abbreviated as ICD 10) assigned the code J03 to acute tonsillitis (a subtype of acute respiratory diseases of the upper respiratory tract).

According to the international classification, acute tonsillitis can be primary or secondary. Primary, in turn, is divided into the following types:

catarrhal is characterized only by superficial damage to the palatine tonsils, a slight increase in size and coating with a thin mucopurulent film;

follicular is an inflammation of the follicular apparatus, manifested in an enlargement of the tonsils and the formation on their surfaces of many yellowish dots of a rounded convex shape;
lacunar is similar to follicular, but has a more severe form - in place of yellowish dots, white-yellow plaques form, filling the cavities of the lacunae.

Causes of the lacunar form of the disease

Human tonsils serve as a filter that absorbs and neutralizes pathogenic microorganisms entering the oral cavity from the outside. When the immune system is weakened, they cannot cope with their function completely. Pathogenic bacteria, entering the body, are attracted by the tonsils, like a sponge, but are not neutralized, but settle and accumulate in the lacunae, causing an inflammatory process and pathological changes on the surface of the tonsils.

The risk group for the occurrence and development of this form of tonsillitis is children, since they do not yet have a fully formed, reliable immune system. The child's body is not able to cope with the huge amount of bacteria coming from outside.

The main causative agents of tonsil disease are streptococci, staphylococci, viruses (especially herpes) and fungi (usually the genus Candida). To a lesser extent, meningococcus, adenovirus, Haemophilus influenzae, and pneumococcus have an effect.

In most cases, the disease develops in children, because, as already mentioned, their immune system is not fully formed and is not yet able to cope with the abundance of pathogenic microorganisms. Various reasons can provoke the development of the disease.

Causes of the disease:

hypothermia in general or only in parts of the body;
exhaustion, overload of the body and, as a result, weakening of the immune system;
chronic form of inflammation in one of the adjacent areas (nose and sinuses near the nose, oral cavity);
injury to the tonsils;
diseases of the autonomic or central nervous system;
contact with an infected person (transmitted by airborne droplets, so isolation of sick people for the period of treatment is mandatory);
caries and other dental diseases (help create a favorable environment for the proliferation of harmful microorganisms in the oral cavity);
difficulty breathing through the nose;
untimely or improper treatment of the first stages of tonsillitis (catarrhal and follicular);
unfavorable external environment (sudden changes in air temperature, polluted atmosphere, high air humidity).

How does the disease progress?

Lacunar-type angina is characterized by a sharp rise in temperature to 38-39°C and the appearance of severe pain in the throat when swallowing. The younger the sick person, the higher the temperature rises at the very beginning. This disease then develops quickly and is severe. Over the course of 2-4 days, there is a significant increase in symptoms.

First of all, characteristic signs of intoxication appear: very high fever, diarrhea, vomiting and possibly even convulsions. Then the sick person begins to feel weak in the body and shivering. There is pain when swallowing and a feeling of soreness and pain in the throat. Turning the head in any direction causes severe pain, radiating to the ear. You can feel enlarged lymph nodes under the lower jaw, and when you press on them, painful sensations appear. Upon examination, the doctor also sees swelling of the tonsils and cheesy white-yellow spots on the lacunae. A characteristic symptom is that these spots, as with a thick coating on the tongue, are simply removed, but after a short period of time they re-form in the same places. Small ulcers are visible under the plaque in the area of the gaps.

The sick person experiences an unpleasant taste in the mouth and a putrid odor. Speech may lose its previous crispness and clarity, and the voice may become more nasal.

Children become lethargic and whiny. They often experience stomach pain and abdominal cramps. There is indigestion. It is important to call a doctor at home as soon as possible at the first manifestations of the disease, so that the pediatrician can quickly prescribe the correct treatment. It is impossible to independently understand that a child has lacunar tonsillitis, since the external signs are similar to many other diseases. Self-medication can lead to tonsillitis becoming chronic. Late medical intervention is fraught with severe intoxication of the child’s body, convulsions, complications in the respiratory and cardiovascular systems, the development of false croup, and severe enlargement of the lymph nodes. The risk of developing pulmonary inflammation in children is especially high if they have previously had their tonsils removed.

To confirm the diagnosis in both children and adults, the doctor examines the mouth with a mirror, takes a smear of mucus from the throat, and also sends for a blood test (detailed).

The recovery period can take from 5 to 14 days, and in case of untimely treatment - a longer period.

Lacunar tonsillitis (ICD code 10 - J03) is treated through three types of therapy aimed at:

elimination of the cause of the disease;
restoration of the body and immunity;
suppression of symptoms (with the help of painkillers, antipyretics).

For the best effect during treatment, it is necessary to isolate the sick person; he must strictly observe sanitary and bed rest, especially in the first days of the disease. It is necessary to ventilate the room well, ensure it has a warm temperature and normal humidity, and maintain cleanliness using wet cleaning.

The patient must have separate utensils.

In order to reduce discomfort in the throat, restore the body's strength and increase immunity, the patient is prescribed light, well-digested food, rich in vitamins and nutrients, that does not irritate the mucous membrane, and drink plenty of fluids throughout the day. Food should not be hot, but warm.

To eliminate the causes of the disease, antimicrobial drugs based on white streptocide (also called sulfanilic acid amide), antibiotics (when an advanced form of sore throat is observed at the time of visiting a doctor) or antifungal agents (if the disease is caused by the Candida fungus) are prescribed. They also use special antimicrobial tablets, aerosols, lozenges and other local antiseptic drugs. The choice of a specific remedy depends on the type of microbes that led to a sore throat, and on the patient’s body’s reaction to a particular medicine.

To cleanse tonsils of white-yellow yeast deposits, use warm solutions and herbal decoctions based on calendula, sage or chamomile. They have good disinfecting ability. They rinse the throat every hour during the day. You can do this yourself. In addition to this, the ENT doctor washes the cavities and ducts of the tonsils (lacunae) with a specially prepared medicinal solution or cleans them using a vacuum.

Patients are prescribed warming compresses, dry heat, therapy with microwaves and ultra-high frequency currents to the place where the lymph nodes are enlarged.

In addition, antihistamines are prescribed. They will reduce swelling of the glands, improve breathing, and reduce the pain that the patient experiences when swallowing.

The above medical prescriptions are aimed at eliminating the acute manifestation of tonsillitis. When stabilization of the condition is achieved, they begin to restore the body (including the microflora of the gastrointestinal tract) and immunity with the help of vitamins, probiotics and a special diet.

The entire course of treatment should be under the constant supervision of a doctor for timely adjustments if regularly taken blood and urine tests show complications that have been transmitted to other organs. As a result, diseases such as acute laryngitis, pneumonia, otitis media, fibrinous tonsillitis, laryngeal edema, and rheumatism may develop.

Lacunar tonsillitis is a very serious disease, so treatment of this disease should be carried out under the guidance of a qualified doctor who, after carrying out diagnostic measures, will prescribe adequate therapy. The exact implementation of the specialist’s instructions depends on the patient and those caring for the patient. In this case, lacunar tonsillitis can be completely cured.

Characteristics of the disease of acute gastroenteritis and disease code according to ICD-10

Each form of inflammation according to the international classification of various diseases has its own separate code. So here is the ICD 10 code for acute gastroenteritis - A09. However, some countries consider this disease as non-infectious, in which case acute gastroenteritis ICD 10 is classified under K52.

1 Pathology according to the international classification

Thanks to the international classification of diseases, used to predict many pathological conditions and diseases, doctors can easily identify any disease, which prevents errors in making a diagnosis. For many doctors around the world, this is an excellent chance to exchange existing experience.

Acute gastroenteritis is an infectious disease caused by various bacteria and viruses that have entered the human body. The small intestine and stomach, or rather their walls, experience the pathological effects of these microorganisms, as a result of which the inflammatory process begins. In addition to infectious, the disease can be allergic or physiological in nature. The main manifestation of the disease is a sharp deterioration in the patient’s health and very unpleasant sensations in the stomach.

Acute gastroenteritis dates back to ancient times, when it had a different name - catarrh of the stomach and intestines. When the cause of the disease was an infection, the patient was diagnosed with gastric fever. But already at the end of the 19th century, the disease received its final name - gastroenteritis, which translated from ancient Greek means “stomach and intestines.”

2 Types of disease and causes of their occurrence

It should be noted that acute gastroenteritis has several varieties:

viral gastroenteritis;
alimentary gastroenteritis;
allergic.

As for infectious gastroenteritis, the causes of its occurrence are microorganisms such as typhus, salmonellosis and even influenza.

A person who abuses spicy and rough foods and alcoholic beverages has every chance of contracting alimentary gastroenteritis. The same type of disease occurs in people who often overeat and do not follow the correct diet.

But allergic gastroenteritis is caused, accordingly, by products - allergens. In some cases, certain medications are allergens, in particular antibiotics, leading to dysbacteriosis. Food poisoning from fish or mushrooms can also lead to the development of the disease.

severe nausea;
vomit;
rumbling in the stomach;
diarrhea, in which the stool has a foul odor and is very foamy;
increased flatulence;
a sharp decrease in appetite;
Painful sensations that are often short-term in nature occur, the main localization of pain is in the navel or throughout the abdomen.

In addition, all of the above symptoms may be accompanied by additional signs, such as:

cold sweat;
the patient’s constant feeling of weakness and loss of strength;
Occasionally, body temperature may rise.

As a result of diarrhea, the amount of which can vary from 5 to 20 times a day, the patient often experiences dehydration, manifested in the following symptoms:

feeling of dryness on the lips and in the mouth;
dry skin;
rare and very small amounts of urination;
low blood pressure;
slow straightening of folds on the body.

If you do not seek help in time, acute gastroenteritis develops into a very severe stage, characterized by sharply onset severe headaches, attacks of dizziness and even fainting. In the absence of adequate prompt treatment, death is possible.

If such signs occur in children or an adult, you should respond immediately.

4 Diagnostic measures

When initial symptoms appear, it is very important to make an accurate diagnosis, and it depends on a correctly collected anamnesis. The patient needs to tell the doctor in detail about his eating habits and preferences, about his diet. The presence of chronic diseases is also important. It is very important for the doctor to identify the true cause of the infection in order to exclude the possibility of developing other diseases of the gastrointestinal tract.

Since the main route of transmission of the disease is through contact, it is necessary to determine whether family members and relatives have similar symptoms.

The patient's oral cavity is also subjected to a thorough examination. During the examination, palpation of the abdomen is also performed. A detailed general analysis of blood, urine and feces is required.

But in order to correctly diagnose the disease and choose an effective, competent method of treating the patient, anamnesis and collected laboratory tests will not be enough. The correctness of the diagnosis fully depends on the instrumental methods used to study the inner surface of the small intestine, such as colonoscopy and ultrasound of the entire abdominal cavity.

Only after thorough diagnostic work with the patient is the doctor able to make an accurate diagnosis, and therefore prescribe treatment, thanks to which the patient will soon feel relief.

After the diagnosis of “acute gastroenteritis” is made, the patient is placed in the infectious diseases department for further treatment. Using sodium bicarbonate, gastric lavage is mandatory.

The first symptoms of acute gastroenteritis are a signal to the patient that he needs to stop eating.

You should drink more fluids. And in general, when making such a diagnosis, for a speedy recovery of the patient, it is necessary to strictly follow a diet. Acute gastroenteritis is a disease in which nutrition must be rational. It is safe to say that the main part of therapeutically effective treatment is diet, which will help speed up the path to recovery.

As already mentioned, acute gastroenteritis is a disease, at the first signs of which the patient should refuse to eat any food. Thus, the load on the entire digestive tract is reduced and thereby the inflammatory process that has begun fades and weakens. The patient's condition is improving. The patient will have to fast for a day or two, after which he can switch to very light food, such as porridge cooked in water, crackers and low-fat broths. As the patient’s health improves, the patient can gradually switch to other types of food.

In addition to dietary treatment, therapy includes:

taking antiviral drugs and some antibiotics;
taking fixatives;
the use of probiotics, their main effect is aimed at quickly restoring the intestinal microflora disturbed by bacteria; enzyme agents will also be useful.

If a person is not treated promptly, he becomes a carrier of the infection. Pathogenic microorganisms spread to other people. Ignoring treatment leads to the fact that the infection spreads very quickly through the blood, which leads to quick death.

Compliance with preventive measures is very important in order to avoid developing acute gastroenteritis. One of the basic vital rules is maintaining personal hygiene, that is, every time you come back from going outside, you must thoroughly wash your hands with soap. You should avoid eating poorly fried or cooked foods. It is necessary to wash fruits and vegetables well before eating them.

How is osteochondrosis designated, ICD-10, international classification of diseases

All known diseases have their own code, including osteochondrosis, ICD-10, the international classification of diseases, denotes them with letters and numbers. According to ICD 10, each type of this disease has its place in it.

Osteochondrosis, ICD code 10

Every ten years, the World Health Organization adopts a new classification of all diseases and health conditions. The tenth version of this document has now been adopted. This system is mandatory for doctors in all countries. It allows you to systematically analyze the health status of the planet's population.

Osteochondrosis is also included in ICD-10. Like all diseases, it is assigned a special code. This disease is classified as class XIII. This class summarizes all pathologies of the skeletal and muscular systems, including connective tissue. Some types of osteochondrosis are classified as dorsopathies. They are alphanumerically coded in ICD 10 and are designated by combinations of letters and numbers.

“Classic” osteochondrosis, ICD 10 code designated as M 42.

Regarding juvenile spinal osteochondrosis, this is M 42.0.
About osteochondrosis of the adult spine, this is M 42.1.
For unspecified osteochondrosis of the spine, this is M 42.9.

In general, diseases of the spine are designated by the letter M and are numbered with numbers ranging from M 40 to M 54. In this form, this disease can be entered into the patient’s individual chart or medical history. In general, the code for this disease depends on the dislocation and degree of damage to the vertebrae, discs, and ligaments.

Osteochondrosis of the cervical spine, ICD code 10

Osteochondrosis of the cervical vertebrae begins to manifest itself at a fairly young age. Its first manifestations can occur in patients even younger than 25 years. The most common symptoms are headache, pain in the vertebrae and soft tissues of the neck, and limited movement.

Osteochondrosis of the cervical spine, ICD 10 code can be designated M 42.1.02 In addition, there are a number of pathologies of the cervical vertebrae and spinal discs, which are designated by code M 50 with additional numbers:

M 50.0 - the disease is accompanied by myelopathy;
M 50.1 - the same changes, but with radiculopathy;
M 50.2 - the disease is associated with displacement of the cervical discs;
M 50.3 - degeneration of various natures of cervical discs;
M 50.8 - other lesions of the cervical discs;
M 50.9 - damage to the cervical discs of unspecified origin.

The diagnosis is made using radiographic images in different projections. They make it possible to determine the location of degenerative and other changes in the structure of the cervical vertebrae and discs. Based on the x-ray, a diagnosis of cervical osteochondrosis will be made, ICD-10, the international classification of diseases, and will help to enter it into the card using a code.

Common spinal osteochondrosis

The human spine or spinal column is the basis of the entire motor and skeletal system of the human body. Any of his diseases affect several systems of internal organs at once. Common osteochondrosis of the spine is one of the most severe ailments of this important part of the body. With this diagnosis, pathological changes can be observed in several departments at once. In this case, the patient exhibits the following symptoms:

Stiffness when walking and other movements.
Pain in the muscles of the back, legs, neck.
Headaches and dizziness.
Fainting conditions.
Numbness of the limbs.

Osteochondrosis affects:

If treatment is not taken, the disease can develop into a chronic form. Periods of remission are followed by sharp exacerbations. This form of osteochondrosis significantly reduces the quality of life in still quite young people. The majority of patients have barely reached the age of 40 - 45 years. At the first manifestations of osteochondrosis, you should consult a doctor to clarify the diagnosis and prescribe adequate treatment.

Lumbar osteochondrosis, ICD code 10

Osteochondrosis most often affects the lumbar region. This is due to functional loads on the vertebrae in the lumbar region. The entire human musculoskeletal system depends on their proper functioning and mobility. They experience increased stress not only in a standing position, but also in a sitting position, when walking, when lifting and carrying heavy objects. Due to the lumbar vertebrae, a person can bend and straighten the body, bend and turn in different directions.

One of the unpleasant manifestations of this form of osteochondrosis is pain. It can catch a person at the most inopportune moment. This is due to the fact that deformed vertebrae and intervertebral discs begin to put pressure on the nerve endings. Lumbar osteochondrosis, code according to ICD 10 is designated mainly as:

Depending on the manifestations and location of the lesions, there may be other codes.

Only a doctor can accurately diagnose the problem. It is based not only on the clinical manifestations of the disease, but also on additional research. First of all, these are x-rays and MRI of the lumbar spine.

Spinal osteochondrosis in adult patients according to ICD 10, causes

According to ICD 10, osteochondrosis of the adult spine is designated M 42.1. Although, depending on the clinical manifestations, there are other pathologies designated as osteochondrosis, the ICD-10 international classification of diseases provides for different designations. This can be the letter M and various digital combinations.

There are many causes of osteochondrosis in adults. All of them, to one degree or another, are associated either with an incorrect lifestyle or a disdainful attitude towards stress, working and rest conditions. The reasons may be:

Hereditary genetic predisposition.
Living in an area with an unfavorable humid and/or cold climate.
Improper, excessive or insufficient nutrition.
Increased loads.
Weak muscle corset.
Various infections.
Hormonal disorders.
Injuries of various types.
Harmful addictions, smoking, alcohol abuse.

Many people mistakenly believe that back problems are common only to old people. Every year, osteochondrosis of the spine becomes “younger.” More and more young people are suffering from it. Timely detection and diagnosis of spinal disease is the key to successful treatment. In advanced cases, surgical treatment cannot be avoided. Good results are achieved by an integrated approach to the treatment of osteochondrosis and the use of folk remedies.

Traditional methods of treating osteochondrosis

In combination with medications prescribed by the doctor, osteochondrosis can be treated with home remedies. Traditional methods of treating osteochondrosis using propolis give good results.

For severe back pain, you can cut a thin plate of propolis ball. Then use a plaster to secure it in the center of the painful area. Propolis warms up from the heat of the human body. Beneficial substances, including bee venom, penetrate through the skin to the source of pain and relieve it.

For regular use you can prepare ointment made from oil and propolis.

To do this, cut 10 g of propolis into 90 g of butter. The mixture is placed in a water bath. Heat to + 70 degrees. While stirring, bring the mixture until the oil and propolis are completely melted. Do not allow the mass to boil. The resulting product is stored in the refrigerator. For a month, a spoonful of it is taken orally before meals three times a day. Apply the ointment externally to the sore area of the back 1-2 times a day.

The number of people with spinal problems increases every year. The increase in the number of patients affected by osteochondrosis, ICD-10, the international classification of diseases, is taken into account in full. Based on these data, analytical work is carried out and recommendations are prepared. You can read reviews on this topic or write your opinion on the forum.

ICD code -10
A08.0. Rotavirus enteritis.

Etiology (causes) of rotavirus infection

Rotavirus schematically

Rotavirus infection, view through an electron microscope

Epidemiology of rotavirus infection

The mechanism of transmission of the pathogen is fecal-oral. Transmission routes:
- contact household (through dirty hands and household items);
- water (when drinking water infected with viruses, including bottled water);
- nutritional (most often when consuming milk and dairy products).

The possibility of airborne transmission of rotavirus infection cannot be ruled out.

After an infection, in most cases, short-term type-specific immunity is formed. Recurrent diseases are possible, especially in older age groups.

Pathogenesis

On the other hand, already on the first day of the disease, rotavirus is detected in the epithelium of the mucous membrane of the duodenum and the upper parts of the jejunum, where it multiplies and accumulates. Penetration of rotavirus into a cell is a multi-stage process. To enter the cell, some rotavirus serotypes require specific receptors containing sialic acid. The important role of proteins has been established: α2β1-integrin, integrin-αVβ3 and hsc70 in the initial stages of interaction between the virus and the cell, while the entire process is controlled by the viral protein VP4. Having penetrated into the cell, rotaviruses cause the death of mature epithelial cells of the small intestine and their rejection from the villi. The cells that replace the villous epithelium are functionally defective and are not able to adequately absorb carbohydrates and simple sugars.

Thus, at present, two main components are distinguished in the development of diarrhea syndrome: osmotic and secretory.

Clinical picture (symptoms) of rotavirus infection

The incubation period ranges from 14–16 hours to 7 days (on average 1–4 days).

A gradual onset of the disease is also possible, with a slow increase in the severity of the process and the development of dehydration, which often leads to late hospitalization.

Symptoms characteristic of mild forms of rotavirus infection:
- low-grade body temperature;
- moderate intoxication for 1–2 days;
- infrequent vomiting;
- loose stool up to 5–10 times a day.

In moderate forms of the disease the following is noted:
- febrile fever;
- severe intoxication (weakness, lethargy, headache, pale skin);
- repeated vomiting within 1.5–2 days;
- copious watery stools from 10 to 20 times a day;
- dehydration of I–II degree.

Complications of rotavirus infection:

Circulatory disorders;
- acute cardiovascular failure;
- acute extrarenal renal failure;
- secondary disaccharidase deficiency;
- intestinal dysbiosis.

Diagnosis of rotavirus infection

The main clinical and diagnostic signs of rotavirus infection:

* characteristic epidemiological history - group nature of the disease in the winter season;
* acute onset of the disease;
* increased body temperature and intoxication syndrome;
* vomiting as a leading symptom;
* watery diarrhea;
* moderate abdominal pain;
* flatulence.

For laboratory confirmation of the rotavirus nature of the disease, three groups of methods are used:
* methods based on the detection of rotavirus and its antigens in feces:
– electron and immunoelectron microscopy;
– RLA;
– ELISA;
* methods for detecting viral RNA in coprofiltrates:
– molecular probe method - PCR and hybridization;
– RNA electrophoresis in polyacrylamide gel or agarose;
* methods for detecting specific antibodies (immunoglobulins of various classes and/or an increase in antibody titer) to rotaviruses in blood serum (ELISA, RSK, RTGA, RNGA).

In practice, the diagnosis of rotavirus infection is most often based on the detection of viral antigen in coprofiltrates using RLA, ELISA on days 1–4 of the disease.

Differential diagnosis

Rotavirus infection is differentiated from cholera, dysentery, escherichiosis, gastrointestinal forms of salmonellosis, and intestinal yersiniosis (Table 18-22).

Indications for consultation with other specialists

An example of a diagnosis formulation

A08.0 Rotavirus infection, gastroenteritis syndrome, moderate form, degree I dehydration.

Treatment of rotavirus infection

Patients with moderate and severe forms of rotavirus infection, as well as patients posing a high epidemiological danger (decreed contingents), are subject to hospitalization.

Complex treatment of rotavirus infection includes nutritional therapy, etiotropic, pathogenetic and symptomatic therapy.

Oral rehydration is carried out with solutions heated to 37–40 °C: glucosolan, citraglucosolan, rehydron. For infusion therapy, polyionic solutions are used.

Considering enzymatic deficiency, it is recommended to use multienzyme agents (such as pancreatin) 1-2 tablets 3 times a day with meals.

In addition, when treating rotavirus infection, it is advisable to include biological products containing bifidobacteria (bifiform 2 capsules 2 times a day).

Table 18-22. Main differential diagnostic signs of acute intestinal infections

Differential diagnostic signs	Shigellosis	Salmo-nellosis	Cholera	Enterotoxic-genic Escherichiasis	Intestinal yersiniosis	Rotavirus infection	Norwalk virus infection
Seasonality	Summer-autumn	Summer-autumn	Spring-summer	Summer	Winter-spring	Autumn-winter	During a year
Fever	2–3 days	3–5 days or more	No	1–2 days	2–5 days	1–2 days	8–12 h
Nausea	±	+	–	+	+	+	+
Vomit	±	Repeated	Repeated, later diarrhea	Repeated	Repeated	Multiple	±
Stomach ache	Contraction-like, in the left iliac region	Moderate, in the epigastrium, near the navel	None	Contraction-like, in the epigastric region	Intense, around the navel or in the right iliac fossa	Rare, moderately expressed in the epigastrium, near the navel	Aching, in the epigastrium, near the navel
Character of the chair	First fecal, then scanty with an admixture of mucus and blood	Copious, watery, fetid, greenish in color, sometimes mixed with mucus	Abundant, watery, in the form of “rice water”, odorless	Abundant, watery, without impurities	Abundant, foul-smelling, often mixed with mucus and blood	Abundant, watery, foamy, yellowish in color, without impurities	Liquid, non-volatile, without pathological impurities
Dehydration	I degree	I–III Art.	I–IV Art.	I–II Art.	I–II Art.	I–II Art.	I Art.
Hemo-gram	Leukocytosis, neutrophilosis	Leukocytosis, neutrophilosis	Leukocytosis, neutrophilosis	Minor leukocytosis	Hyperleukocytosis, neutrophilosis	Leukopenia, lymphocytosis	Leukocytosis, lymphopenia

Recovery prognosis

The prognosis is usually favorable. Those who have recovered from the disease are discharged upon complete clinical recovery, which occurs in most cases by 5–7 days from the onset of the disease.

Dispensary observation is not carried out.

After the illness, the patient is recommended to follow a diet with limited milk, dairy products, and carbohydrates for 2–3 weeks.

ICD-10 CODE

A08.0. Rotavirus enteritis.

ETIOLOGY

The pathogen is a member of the family Reoviridae, kind Rotavirus. The name is based on the morphological similarity of rotaviruses to a wheel (from the Latin " rota" - "wheel"). Under an electron microscope, viral particles look like wheels with a wide hub, short spokes and a clearly defined thin rim. The rotavirus virion with a diameter of 65-75 nm consists of an electron-dense center (core) and two peptide shells: an outer and an inner capsid The core with a diameter of 38-40 nm contains internal proteins and genetic material represented by double-stranded RNA. The genome of human and animal rotaviruses consists of 11 fragments, which probably determines the antigenic diversity of rotaviruses. Replication of rotaviruses in the human body occurs exclusively in the epithelial cells of the small intestine. .

Four main antigens have been found in rotaviruses; the main one is the group antigen - the protein of the internal capsid. Taking into account all group-specific antigens, rotaviruses are divided into seven groups: A, B, C, D, E, F, G. Most human and animal rotaviruses belong to group A, within which subgroups (I and II) and serotypes are distinguished. Subgroup II includes up to 70-80% of strains isolated from patients. There is evidence of a possible correlation between certain serotypes and the severity of diarrhea.

Rotaviruses are resistant to environmental factors: in drinking water, open reservoirs and wastewater they persist for up to several months, on vegetables - 25-30 days, on cotton, wool - up to 15-45 days. Rotaviruses are not destroyed by repeated freezing, under the influence of disinfectant solutions, ether, chloroform, ultrasound, but they die when boiled, treated with solutions with a pH of more than 10 or less than 2. Optimal conditions for the existence of viruses: temperature 4 ° C and high (>90%) or low (‹13%) humidity. Infectious activity increases with the addition of proteolytic enzymes (eg, trypsin, pancreatin).

Acute gastroenteritis is mostly infectious in nature. The microorganisms that cause this disease have a pathological effect on the walls of the small intestine and stomach, and as a result, these organs become inflamed. But it may also be of unspecified etiology. The onset of the disease can be recognized by certain symptoms that correspond to its form, the type of infectious agent that caused the pathology, the etiology and severity of the course. Gastroenteritis of moderate severity is accompanied by the following symptoms:

Acute gastroenteritis always manifests itself as stool upset and nausea, often leading to vomiting;
The stool changes color to greenish or orange with inclusions of mucous or blood;
The consistency of the stool becomes liquid and has an unpleasant odor, and a large amount of gas accumulates in the intestines;
Severe pain is localized in the epigastric area, which can be diffuse or concentrated around the navel.

These symptoms of acute gastroenteritis are frequent and intensify during meals. With an exacerbation of the pathology, the presence of intoxication in the body is also strongly expressed, which can be determined by a sharp decrease in appetite and an increase in temperature to critical and febrile levels, malaise, weakness, and lethargy.

In case of severe exacerbation of gastroenteritis, dehydration of the body is added to the listed symptoms, which is very dangerous and in the absence of immediate adequate treatment can be fatal. Dehydration is recognized in both adult patients and children in the acute form of the pathology by the following signs:

Skin turgor decreases;
The tongue and mucous membranes become dry;
The skin and hair also become very dry.

All these signs usually accompany an exacerbation of moderate gastroenteritis and its transition to the next, practically incurable form.

Causes and diagnosis of acute gastroenteritis

The culprits for the development of acute gastroenteritis in an adult patient can be various bacteria and viruses, as well as food poisoning, alcohol abuse or long-term use of antibiotics. Each of these factors can upset the balance of microflora in the intestines and stomach and cause an attack that develops against the background of dietary errors or decreased immunity. Since the main factors that cause the development of this disease are quite diverse, very often the diagnosis is initially made of acute gastroenteritis of unspecified etiology of mild or moderate severity.

But due to the fact that the correctness of the diagnosis of acute gastroenteritis, as well as the choice of treatment method, depends on the pathogen that provoked the onset of the development of the pathology, the most accurate diagnosis is necessary, which consists not only of a thorough collection of anamnesis and biological material for laboratory research, but also the use of instrumental methods (colonoscopy, sigmoidoscopy). An ultrasound of the abdominal cavity is also required. The diagnosis algorithm is something like this:

A complete history of the disease is required (time and approximate cause of the onset of symptoms such as abdominal pain, diarrhea and vomiting);
A life history is also collected from adults, which indicates food culture, the presence of chronic diseases and bad habits;
A family history is also required, which will indicate the presence of gastrointestinal diseases in close relatives and the frequency of exacerbations.

In addition to clarifying these factors in the patient’s life, the diagnosis of acute gastroenteritis involves an initial examination of the abdomen, skin and tongue, laboratory tests of stool, blood and vomit, as well as an instrumental method for visual examination of the inner surface of the small intestine. Only after such thorough research does a specialist have the opportunity to make a more accurate diagnosis and select the correct treatment method, which should be based on the patient’s adherence to a strict diet.

How is acute gastroenteritis transmitted?

When a person develops symptoms of this pathology, the first thought that arises will be: “How is it transmitted, where did I pick it up?” To this patient’s question, any specialist will answer that the disease is very easily transmitted if basic hygiene rules are not observed from one person to another and in the absence of adequate therapy or self-medication, it ends in dehydration, collapse and death.

Infection when communicating with a patient suffering from this disease occurs both through close contact, kissing, and when using shared utensils. In addition, to the question of how acute gastroenteritis is transmitted, one can answer that it is very easy to catch it by eating foods that have not undergone sufficient heat treatment, or poorly washed vegetables and fruits, as well as through dirty hands. The incubation period for this disease can last from 1 to 4 days, after which all the symptoms accompanying this disease will appear.

ICD 10 code for acute gastroenteritis

To make it easier to classify this pathology, which has several varieties, and select the appropriate treatment in the international classification of diseases (ICD 10), it is assigned code K52. Under it are collected all possible types of gastroenteritis, as well as the phases of its exacerbation.

Thanks to this reference book, used to monitor morbidity and all other health-related problems, specialists are able to easily identify developing pathologies, which helps to avoid inaccuracies in the name of the disease when making a diagnosis, and also allows doctors from different countries to exchange professional experience.

For example, in the case when a gastroenterologist marks the ICD 10 code K-52.1 in the patient’s medical history, this means that he is classified as toxic gastroenteritis. If additional information is needed on the substance that caused the acute form of this disease, an additional external cause code is used. Thanks to this classification, doctors all over the world can apply uniform tactics in the treatment of this disease.

The role of diet in the treatment of acute gastroenteritis

To achieve a speedy recovery of patients with this disease, all types of therapy should be carried out only in conjunction with an appropriate diet. Acute gastroenteritis, occurring against the background of inflammatory processes, requires attention to the organization of a balanced diet.

Diet in acute forms of the disease becomes an integral part of therapy and helps speed up the recovery process. At the very first signs of illness, you must completely stop eating any food. This will reduce the load on the digestive organs, reduce the inflammatory process and alleviate the patient’s general condition. In the same case, if there is no adequate treatment for the disease, the prognosis for the patient may well be collapse or death.

Acute gastroenteritis

Infectious infection has its own designation. The A09 clarification is added to the main code. There are also subsections that determine the nature of the disease.

What do ICD 10 codes define?

Since diseases of the digestive system can be chronic, appear as a result of poor diet or infection, it is necessary to make an accurate diagnosis of the patient. This will allow you to choose the right course of treatment and reduce the number of entries in the medical history. In ICD 10 code for gastroenteritis of a non-infectious nature designated as K52. In this case, a clarification is added through a period, for example, “K52.2 - allergic or alimentary gastroenteritis and colitis.”

Symptoms of acute gastroenteritis

Non-infectious enteritis occurs for various reasons, but the development of the disease manifests itself in the same way in most cases.

Patients experience:

Causes of gastroenteritis

Despite the prevalence of the disease, it does not occur in all circumstances. According to ICD 10, acute gastroenterocolitis is a non-infectious disease, but the causes of its occurrence are:

Viruses and bacteria. There are a lot of them. The main ones include: rota viruses, campylobacter, noravirus, salmonella, etc.
Long-term use of antibiotics in the treatment of prostatitis, as well as other organs associated with the digestive and urinary systems. During the use of drugs, the balance of the microflora of the gastrointestinal tract is disrupted.

It is also worth noting the influence of external factors that contribute to the rapid development of the disease. These include:

consumption of thermally unprocessed foods;
close contact with a carrier of infection;
consumption of expired products.

Also the cause may be the development of gastritis. The intestines directly interact with the stomach, so complications are transmitted to the interacting organs.

Prevention of acute gastroenteritis

To avoid intestinal problems, it is necessary to prevent the possibility of disease occurring.

The main forms of prevention are:

periodic bowel examinations;
refusal to eat raw foods;
observing personal hygiene rules after contact with an infected person;
Thorough washing of fruits and vegetables.

Infectious diseases, pharmacotherapy

Rotavirus gastroenteritis

ICD-10: A08.0

Rotavirus gastroenteritis(syn. rotavirus infection) is an acute anthroponotic viral disease with a fecal-oral transmission mechanism, characterized by general intoxication, affecting the mucous membranes of the small intestine and oropharynx with the leading syndrome of gastroenteritis and dehydration of the body.

Brief historical information. According to WHO, rotavirus gastroenteritis causes the death of 1 to 3 million children every year. Rotavirus infection accounts for about 25% of cases of so-called “travelers' diarrhea.” In tropical countries, it is recorded all year round, with a slight increase in incidence in the cool rainy season. In countries with temperate climates, seasonality is quite pronounced, with the highest incidence in the winter months. Rotavirus gastroenteritis is quite widespread in Ukraine: both sporadic diseases and outbreaks are recorded. High focality is characteristic in organized groups, especially children's educational institutions. The disease often manifests itself in group outbreaks during nosocomial infection in maternity hospitals and children's medical hospitals of various profiles. In maternity hospitals, children who are bottle-fed, suffering from acute and chronic diseases, and with various types of immunodeficiency are more likely to get sick. Clinical manifestations of the disease in the form of large outbreaks have been known since the end of the 19th century. The pathogen was first isolated and described by R. Bishop et al. (1973). In many regions of the world, the incidence of rotavirus gastroenteritis ranks second after the incidence of acute respiratory viral infections.

Pathogen– RNA genomic virus of the Rotavirus genus of the Reoviridae family. It received its generic name due to the resemblance of the virions (under an electron microscope) to small wheels with a thick hub, short spokes and a thin rim (Latin rota, wheel). Based on their antigenic properties, rotaviruses are divided into 9 serotypes; lesions in humans are caused by serotypes 1-4 and 8-9, other serotypes (5-7) are isolated in animals (the latter are not pathogenic for humans). Rotaviruses are stable in the external environment. On various environmental objects they remain viable from 10-15 days to 1 month. in feces – up to 7 months. They remain in tap water at 20-40 °C for more than 2 months; on vegetables and herbs at a temperature of +4° C – 25-30 days.

Epidemiology

Source of infection– a person (sick and virus carrier). The patient poses an epidemic danger during the first week of the disease, then its contagiousness gradually decreases. In some patients, the period of virus isolation can last up to 20-30 days or more. Individuals without clinical manifestations of the disease can shed the pathogen for up to several months. In foci of infection, asymptomatic carriers of rotaviruses are more often identified among adults, while the main group of patients with acute rotavirus gastroenteritis are children. Asymptomatic carriers of the virus are of great importance, especially among children in the first year of life, who most often become infected from their mothers. Adults and older children become infected from sick children attending organized children's groups. The transmission mechanism is fecal-oral, transmission routes are water, food and household. The most important role is played by the water transmission route of the pathogen. Contamination of water in open reservoirs can occur when untreated wastewater is discharged. If water from central water pipelines is contaminated, a large number of people may become infected. Among food products, milk and dairy products are dangerous if they become infected during processing, storage or sale. Less commonly, viruses are transmitted by airborne droplets. Contact-household transmission is possible in the family and in hospital settings. Natural susceptibility to infection is high. Children under 3 years of age are most susceptible. Nosocomial infection is most often recorded among newborns who have an unfavorable premorbid background and are bottle-fed. Their gastroenteritis occurs mainly in a severe form. The risk group also includes older people and people with concomitant chronic pathologies. Post-infectious immunity does not last long.

Pathogenesis

The entry gate for the virus is the mucous membrane of the small intestine, mainly the duodenum and the upper jejunum. When entering the small intestine, viruses penetrate into differentiated adsorbing functionally active cells of the villi of its proximal section, where pathogen reproduction occurs. Reproduction of viruses is accompanied by a pronounced cytopathic effect. The synthesis of digestive enzymes, primarily those that break down carbohydrates, decreases. As a result, the digestive and absorption functions of the intestine are disrupted, which is clinically manifested by the development of osmotic diarrhea.

Pathomorphology. Rotavirus infection leads to morphological changes in the intestinal epithelium - shortening of microvilli, crypt hyperplasia and moderate infiltration of the lamina propria. The circulation of rotaviruses is usually limited to the mucous membrane of the small intestine, but in some cases viruses can be found in the lamina propria of the mucous membrane and even regional lymph nodes. Reproduction of viruses in remote areas and their dissemination are observed only in immunodeficiencies.

Clinical picture

The incubation period lasts from 1 to 7 days, more often 2-3 days. The disease begins acutely, with the simultaneous appearance of repeated or repeated vomiting, nausea and diarrhea. Usually, single or repeated vomiting stops within the first day, and with a mild course of the disease it may not occur at all. Diarrhea lasts up to 5-7 days. The stools are liquid, foul-smelling, yellow-green in color. Blood in the stool and tenesmus are not typical.

The patient is worried about severe general weakness, poor appetite, heaviness in the epigastric region, and sometimes headache. Moderate cramping or persistent abdominal pain is often noted. They can be diffuse or localized (in the epigastric and periumbilical areas). The sudden urge to defecate is imperative. In mild cases of the disease, the stool is mushy and fecal in nature, no more than 5-6 times a day. In cases of moderate severity and severe disease, the frequency of bowel movements increases to 10-15 times a day or more, the stool is liquid, profuse, foul-smelling, foamy, yellow-green or cloudy white. An admixture of mucus and blood in the stool, as well as tenesmus, are uncharacteristic. When examining patients, attention is drawn to pronounced adynamia and sounds of intestinal peristalsis audible at a distance. The tongue is coated, there may be teeth marks along its edges. The mucous membrane of the oropharynx is hyperemic, granularity and swelling of the uvula are noted. The abdomen is moderately painful in the epigastric, umbilical and right iliac regions. On palpation of the cecum, a rough rumbling is noted. The liver and spleen are not enlarged. Some patients exhibit a tendency to bradycardia and muffled heart sounds. Body temperature remains normal or rises to low-grade levels, but in severe cases of the disease it can be high. In severe forms, it is possible to develop disturbances in water-salt metabolism with circulatory failure, oliguria and even anuria, and an increase in the content of nitrogenous substances in the blood. A characteristic feature of this disease, which distinguishes it from other intestinal infections, is the simultaneous development of clinical manifestations of the upper respiratory tract in the form of rhinitis, nasopharyngitis or pharyngitis. In adults, rotavirus gastroenteritis usually occurs subclinically. Manifest forms can be observed in parents of sick children, in people who have visited developing countries, and in immunodeficiencies, including the elderly.

Complications

Complications are rare. It is necessary to take into account the possibility of secondary bacterial infection, which leads to changes in the clinical picture of the disease and requires a different therapeutic approach. The features of the course of rotavirus infection in people with immunodeficiencies (HIV-infected, etc.) have not been sufficiently studied. Necrotizing enterocolitis and hemorrhagic gastroenteritis may occur.

Diagnostics

Rotaviruses can be isolated from feces, especially in the first days of illness. To preserve feces, prepare a 10% suspension in Hanks' solution. Paired sera are examined in RCA, RLA, RSK, ELISA, immunoprecipitation reactions in gel and immunofluorescence (RIF) in order to detect and determine the increase in antibody titer in the dynamics of the disease. Specific antibodies in the patient’s blood are detected using rotavirus antigens that infect animals (calves). Serological diagnosis is retrospective in nature, since confirmation of the diagnosis is considered to be at least a 4-fold increase in antibody titers in paired sera taken in the first days of the disease and after 2 weeks.

Differential diagnosis

Rotavirus gastroenteritis should be distinguished from other acute intestinal infections of various etiologies (shigellosis, salmonellosis, escherichiosis, acute intestinal infections caused by opportunistic microorganisms, other viral diarrheas). The greatest difficulties are caused by diarrheal diseases caused by other viruses (coronaviruses, caliciviruses, astroviruses, intestinal adenoviruses, Norwalk virus, etc.), the clinical picture of which has not yet been sufficiently studied.

There are no specific or etiotropic drugs. In the acute period of the disease, a diet with limited carbohydrates (sugar, fruits, vegetables) and the exclusion of foods that cause fermentation processes (milk, dairy products) is necessary. Taking into account the peculiarities of the pathogenesis of the disease, it is desirable to prescribe multienzyme drugs - abomin, polyzyme, panzinorma-forte, pancreatin, festal, etc. Recently, mexase has been successfully used. The combination of these drugs with intestopan and nitroxoline is beneficial. Adsorbent and astringent agents are indicated. Correction of water and electrolyte losses and detoxification therapy are carried out according to general principles. In case of dehydration of I or II degree, glucose-electrolyte solution is administered orally. According to WHO recommendations, use the following solution: sodium chloride - 3.5 g, potassium chloride - 1.5 g, sodium bicarbonate - 2.5 g, glucose - 20 g per 1 liter of drinking water. An adult patient is given the solution to drink in small doses (30-100 ml) every 5-10 minutes. You can give Ringer's solution with the addition of 20 g of glucose per 1 liter of solution, as well as a solution 5, 4, 1 (5 g of sodium chloride, 4 g of sodium bicarbonate, 1 g of potassium chloride per 1 liter of water) with the addition of glucose. In addition to solutions, other liquids are given (tea, fruit juice, mineral water). The amount of fluid depends on the degree of dehydration and is controlled by clinical data; when rehydration is achieved, replenishment of body fluid is carried out in accordance with the amount of fluid lost (volume of stool, vomit). In severe degrees of dehydration, rehydration is carried out by intravenous administration of solutions. Since in most cases the dehydration of patients is mild or moderate, it is sufficient to prescribe oral rehydrants (Oralit, Rehydron, etc.).

Prevention

The basis is general hygienic measures aimed at preventing the entry and spread of pathogens through water, food and household routes. The complex of sanitary and hygienic measures includes improving the environment, strict adherence to sanitary standards for water supply to the population, sewerage, as well as strict adherence to personal hygiene rules. A number of countries are developing and successfully using vaccines that have fairly high preventive effectiveness.

Rotavirus infection

ICD code -10

A08.0. Rotavirus enteritis.

Etiology (causes) of rotavirus infection

Rotavirus schematically

Rotavirus infection, view through an electron microscope

Epidemiology of rotavirus infection

The mechanism of transmission of the pathogen is fecal-oral. Transmission routes:

— contact household (through dirty hands and household items);

- water (when drinking water infected with viruses, including bottled water);

— nutritional (most often when consuming milk and dairy products).

The possibility of airborne transmission of rotavirus infection cannot be ruled out.

After an infection, in most cases, short-term type-specific immunity is formed. Recurrent diseases are possible, especially in older age groups.

Pathogenesis

Thus, at present, two main components are distinguished in the development of diarrhea syndrome: osmotic and secretory.

Clinical picture (symptoms) of rotavirus infection

The incubation period ranges from 14–16 hours to 7 days (on average 1–4 days).

A gradual onset of the disease is also possible, with a slow increase in the severity of the process and the development of dehydration, which often leads to late hospitalization.

Symptoms characteristic of mild forms of rotavirus infection:

- low-grade body temperature;

— moderate intoxication for 1–2 days;

- infrequent vomiting;

- loose stool up to 5-10 times a day.

In moderate forms of the disease the following is noted:

- febrile fever;

- severe intoxication (weakness, lethargy, headache, pale skin);

- repeated vomiting within 1.5–2 days;

- copious watery stools from 10 to 20 times a day;

— dehydration of I–II degree.

Complications of rotavirus infection:

- circulatory disorders;

— acute cardiovascular failure;

- acute extrarenal renal failure;

- secondary disaccharidase deficiency;

- intestinal dysbiosis.

Diagnosis of rotavirus infection

The main clinical and diagnostic signs of rotavirus infection:

* characteristic epidemiological history - group nature of the disease in the winter season;

* acute onset of the disease;

* increased body temperature and intoxication syndrome;

* vomiting as a leading symptom;

* watery diarrhea;

* moderate abdominal pain;

* flatulence.

For laboratory confirmation of the rotavirus nature of the disease, three groups of methods are used:

* methods based on the detection of rotavirus and its antigens in feces:

– electron and immunoelectron microscopy;

* methods for detecting viral RNA in coprofiltrates:

– molecular probe method - PCR and hybridization;

– RNA electrophoresis in polyacrylamide gel or agarose;

* methods for detecting specific antibodies (immunoglobulins of various classes and/or an increase in antibody titer) to rotaviruses in blood serum (ELISA, RSK, RTGA, RNGA).

In practice, the diagnosis of rotavirus infection is most often based on the detection of viral antigen in coprofiltrates using RLA, ELISA on days 1–4 of the disease.

Differential diagnosis

Rotavirus infection is differentiated from cholera, dysentery, escherichiosis, gastrointestinal forms of salmonellosis, and intestinal yersiniosis (Table 18-22).

Indications for consultation with other specialists

An example of a diagnosis formulation

A08.0 Rotavirus infection, gastroenteritis syndrome, moderate form, degree I dehydration.

Treatment of rotavirus infection

Patients with moderate and severe forms of rotavirus infection, as well as patients posing a high epidemiological danger (decreed contingents), are subject to hospitalization.

Complex treatment of rotavirus infection includes nutritional therapy, etiotropic, pathogenetic and symptomatic therapy.

Oral rehydration is carried out with solutions heated to 37–40 °C: glucosolan, citraglucosolan, rehydron. For infusion therapy, polyionic solutions are used.

Considering enzymatic deficiency, it is recommended to use multienzyme agents (such as pancreatin) 1-2 tablets 3 times a day with meals.

In addition, when treating rotavirus infection, it is advisable to include biological products containing bifidobacteria (bifiform 2 capsules 2 times a day).

Table 18-22. Main differential diagnostic signs of acute intestinal infections

Differential diagnostic signs

Rotavirus gastroenteritis according to ICD 10. Viral intestinal infections in children. Epidemiology of rotavirus infection

Herpes and the classification system

Infections caused by HSV

Infections caused by herpes type 3

Features of felon according to ICD-10

Chronic paronychia

Treatment of paronychia and panaritium

Rotavirus infection

Etiology (causes) of rotavirus infection

Epidemiology of rotavirus infection

Clinical picture (symptoms) of rotavirus infection

Complications of rotavirus infection:

Diagnosis of rotavirus infection

Differential diagnosis

Indications for consultation with other specialists

An example of a diagnosis formulation

Treatment of rotavirus infection

What is the ICD 10 code for lacunar tonsillitis and how does the disease manifest?

Causes of the lacunar form of the disease

How does the disease progress?

Characteristics of the disease of acute gastroenteritis and disease code according to ICD-10

1 Pathology according to the international classification

2 Types of disease and causes of their occurrence

4 Diagnostic measures

How is osteochondrosis designated, ICD-10, international classification of diseases

Osteochondrosis, ICD code 10

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Etiology (causes) of rotavirus infection

Epidemiology of rotavirus infection

Pathogenesis

Clinical picture (symptoms) of rotavirus infection

Complications of rotavirus infection:

Diagnosis of rotavirus infection

Differential diagnosis

Indications for consultation with other specialists

An example of a diagnosis formulation

Treatment of rotavirus infection

Recovery prognosis

ICD-10 CODE

ETIOLOGY

Causes and diagnosis of acute gastroenteritis

How is acute gastroenteritis transmitted?

ICD 10 code for acute gastroenteritis

The role of diet in the treatment of acute gastroenteritis

Acute gastroenteritis

What do ICD 10 codes define?

Symptoms of acute gastroenteritis

Patients experience:

Causes of gastroenteritis

Prevention of acute gastroenteritis

The main forms of prevention are:

Infectious diseases, pharmacotherapy

Rotavirus gastroenteritis

Epidemiology

Pathogenesis

Clinical picture

Diagnostics

Prevention

Rotavirus infection

Etiology (causes) of rotavirus infection

Epidemiology of rotavirus infection

Pathogenesis

Clinical picture (symptoms) of rotavirus infection

Complications of rotavirus infection:

Diagnosis of rotavirus infection

Differential diagnosis

Indications for consultation with other specialists

An example of a diagnosis formulation

Treatment of rotavirus infection

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