Causes of Vomiting in Children with URTI

Primary Mechanism in URTI

Fever when present in uncomplicated viral URI tends to occur early (first 24-48 hours) along with constitutional symptoms, then respiratory symptoms become more prominent, as noted by the American Academy of Pediatrics 1

Acute otitis media commonly follows viral URTI, occurring on days 2-5 after URTI onset in up to two-thirds of young children with viral infections, according to the American Academy of Pediatrics 2
This age group (18 months) is at peak risk for AOM development, as reported by the American Academy of Pediatrics 2
Examine for red and bulging tympanic membrane, ear pain, irritability, and fever, as recommended by the American Academy of Pediatrics 2

UTI presents with nonspecific symptoms in this age group, including vomiting, fever, and irritability without clear urinary symptoms, as noted by the American College of Radiology 3
The prevalence is 0.1-1% in young children, with presentation often mimicking other infections, according to the American College of Radiology 3

Suspect when URTI symptoms persist beyond 10 days without improvement or when there is severe onset with high fever and purulent nasal discharge for 3-4 consecutive days, as recommended by the American Academy of Pediatrics 1
The concurrent presentation of high fever and purulent discharge early in illness distinguishes bacterial sinusitis from uncomplicated viral URI, according to the American Academy of Pediatrics 1

Severe dehydration, characterized by sunken eyes, decreased urine output, and lethargy, requires immediate evaluation, as recommended by the Centers for Disease Control and Prevention 6

Manage vomiting with small, frequent volumes of oral rehydration solution, as recommended by the Centers for Disease Control and Prevention 6
Continue age-appropriate diet, including full-strength formula or breast milk, with starches, cereals, yogurt, fruits, and vegetables for solid foods, as recommended by the Centers for Disease Control and Prevention 6
Replace each episode of vomiting with 10 mL/kg of ORS, as recommended by the Centers for Disease Control and Prevention 6