Association Between Laboratory Findings and Clinical Features of Diarrheal Illness in Hospitalized Pediatric Patients Across Different Age Groups
DOI:
https://doi.org/10.52340/GBMN.2026.01.01.170Keywords:
C-reactive protein, Diarrheal illness, Inflammatory markers, Pediatrics, Stool erythrocytes, Stool leukocytes, White blood cell countAbstract
BACKGROUND. Acute diarrheal illnesses are a common problem in the pediatric population and remain highly prevalent worldwide, especially in developing countries, where they represent one of the leading causes of mortality in children under five years of age. However, the association between the clinical severity of diarrheal illness and elevated inflammatory markers remains poorly characterized. OBJECTIVES. To evaluate the association between laboratory findings and clinical features of diarrheal illness in hospitalized pediatric patients. METHODS. A hospital-based descriptive study was conducted among 223 hospitalized pediatric patients aged 29 days to 18 years with acute febrile diarrheal illnesses in 2025. After exclusions, the final sample comprised 190 patients. Demographic, clinical, and laboratory data were collected from medical records. Continuous variables were analyzed using the Kruskal–Wallis test, and categorical variables using Fisher’s exact test. RESULTS. The patients demonstrated a wide range of changes in inflammatory markers, as well as stool leukocytes and erythrocytes. Most clinical characteristics did not differ significantly across age groups; however, the number of vomiting episodes did (p=0.006), and the degree of dehydration also differed, with severe dehydration more common in infants (p=0.037). Stool erythrocyte findings were associated with the number of diarrheal episodes (p=0.003), the presence of gross blood in stool (p<0.001), and tenesmus (p<0.001). Elevated CRP levels were associated with a higher degree of fever at admission (p=0.039), and elevated ESR levels were associated with a higher number of diarrheal episodes (p=0.049). Lymphocyte levels were associated with the number of vomiting episodes (p=0.025). CONCLUSIONS. Elevations in inflammatory markers in hospitalized children with diarrheal illnesses were variable and not uniformly associated with illness severity. However, certain laboratory findings were associated with specific clinical manifestations and may assist in clinical evaluation and management of hospitalized pediatric patients.References
Pediatric Infectious Diseases Department, Tbilisi State Medical University, Tbilisi, Georgia
Children’s Infectious Diseases Hospital, Tbilisi, Georgia
Ken Walker International University, Tbilisi, Georgia
World Health Organization. Diarrhoeal disease. Published March 7, 2024. Accessed [date]. https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease
UpToDate. Diagnostic approach to diarrhea in children in resource-abundant settings. Published 2026. Accessed January 10, 2026. https://www.uptodate.com/contents/diagnostic-approach-to-diarrhea-in-children-in-resource-abundant-settings
Guerrant RL, Van Gilder T, Steiner TS, et al. Practice guidelines for the management of infectious diarrhea. Clin Infect Dis. 2001;32(3):331-351. doi:10.1086/318514
Viviano L, Huntwork M. Inflammatory markers in pediatrics. Pediatr Rev. 2025;46(4):231-233. doi:10.1542/pir.2024-006453
Kliegman RM, Marcdante KJ. Nelson Essentials of Pediatrics. 8th ed. Elsevier; 2019.
Shane AL, Mody RK, Crump JA, et al. 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea. Clin Infect Dis. 2017;65(12):e45-e80. doi:10.1093/cid/cix669
Tishkowski K, Gupta V. Erythrocyte sedimentation rate. In: StatPearls. Published 2023. Accessed [date]. https://www.ncbi.nlm.nih.gov/books/NBK557485/
Dolin R, Reichman RC, Fauci AS. Lymphocyte populations in acute viral gastroenteritis. Infect Immun. 1976;14(2):422-428. doi:10.1128/iai.14.2.422-428.1976
