{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T03:44:17Z","timestamp":1778125457659,"version":"3.51.4"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2021,5,16]],"date-time":"2021-05-16T00:00:00Z","timestamp":1621123200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Collaborative Research Innovation Opportunity"},{"DOI":"10.13039\/100012856","name":"Alberta Children\u2019s Hospital Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012856","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003206","name":"Alberta Children\u2019s Hospital Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003206","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010090","name":"Women and Children\u2019s Health Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010090","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008459","name":"University of Calgary","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008459","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>As children with isolated vomiting are rarely able to provide a specimen suitable for routine pathogen testing, we have limited knowledge about their infecting pathogens.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Between December 2014 and August 2018, children &amp;lt;18 years old with presumed acute gastroenteritis who presented to 2 emergency departments (EDs) in Alberta, Canada, were recruited. Eligible participants had \u22653 episodes of vomiting and\/or diarrhea in a 24-hour period, &amp;lt;7 days of symptoms, and provided a rectal swab or stool specimen. We quantified the proportion of children with isolated vomiting in whom an enteropathogen was identified, and analyzed clinical characteristics, types of enteropathogens, resources used, and alternative diagnoses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 2695 participants, at the ED visit, 295 (10.9%), 1321 (49.0%), and 1079 (40.0%) reported having isolated diarrhea, vomiting and diarrhea, or isolated vomiting, respectively. An enteropathogen was detected most commonly in those with vomiting and diarrhea (1067\/1321; 80.8%); detection did not differ between those with isolated diarrhea (170\/295; 57.6%) and isolated vomiting (589\/1079; 54.6%) (95% confidence interval of the difference: \u22123.4%, 9.3%). Children with isolated vomiting most often had a virus (557\/1077; 51.7%), most commonly norovirus (321\/1077; 29.8%); 5.7% (62\/1079) had a bacterial pathogen. X-rays, ultrasounds, and urine tests were most commonly performed in children with isolated vomiting. Alternate etiologies were most common in those with isolated vomiting (5.7%; 61\/1079).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The rate of enteropathogen identification in children with isolated vomiting using molecular diagnostic tests and rectal swabs is substantial. Molecular diagnostics offer an emerging diagnostic strategy in children with isolated vomiting.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciab451","type":"journal-article","created":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T19:21:17Z","timestamp":1620847277000},"page":"1414-1423","source":"Crossref","is-referenced-by-count":16,"title":["Microbial Etiologies and Clinical Characteristics of Children Seeking Emergency Department Care Due to Vomiting in the Absence of Diarrhea"],"prefix":"10.1093","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2319-6192","authenticated-orcid":false,"given":"Stephen B","family":"Freedman","sequence":"first","affiliation":[{"name":"Division of Pediatric Emergency Medicine and Gastroenterology, Department of Pediatrics and Emergency Medicine, Alberta Children\u2019s Hospital, Alberta Children\u2019s Hospital Research Institute, Cumming School of Medicine, University of Calgary , Calgary, Alberta , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianling","family":"Xie","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Department of Pediatrics, Cumming School of Medicine, University of Calgary , Calgary, Alberta , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bonita E","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine and Dentistry, Women and Children\u2019s Health Research Institute, University of Alberta , Edmonton, Alberta , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samina","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine and Dentistry, Women and Children\u2019s Health Research Institute, University of Alberta , Edmonton, Alberta , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Li","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Laboratory of Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta , Edmonton, Alberta , Canada"},{"name":"Public Health Laboratory, Alberta Precision Laboratories , Edmonton, Alberta , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Chui","sequence":"additional","affiliation":[{"name":"Department of Laboratory of Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta , Edmonton, Alberta , Canada"},{"name":"Public Health Laboratory, Alberta Precision Laboratories , Edmonton, Alberta , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ran","family":"Zhuo","sequence":"additional","affiliation":[{"name":"Department of Laboratory of Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta , Edmonton, Alberta , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Otto G","family":"Vanderkooi","sequence":"additional","affiliation":[{"name":"Section of Pediatric Infectious Diseases, Department of Pediatrics, Microbiology, Immunology, and Infectious Diseases, Pathology and Laboratory Medicine and Community Health Sciences. Alberta Children\u2019s Hospital, Alberta Children\u2019s Hospital Research Institute, Cumming School of Medicine, University of Calgary , Calgary, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond","family":"Tellier","sequence":"additional","affiliation":[{"name":"Department of Medicine, McGill University and Optilab Montreal, McGill University Health Centre , Montreal, Quebec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna L","family":"Funk","sequence":"additional","affiliation":[{"name":"Section of Pediatric Emergency Medicine, Department of Pediatrics, Alberta Children\u2019s Hospital, Alberta Children\u2019s Hospital Research Institute, Cumming School of Medicine, University of Calgary , Calgary, Alberta , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip I","family":"Tarr","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology, Hepatology & 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