In our study, we examined clinical and laboratory characteristics of hospitalized children with acute diarrheal illnesses and analyzed how the findings differed across age groups and laboratory parameters. Most clinical characteristics were similar across age groups, which suggests that, in general, the clinical presentation of acute diarrheal illnesses does not vary significantly with age. However, we observed some important differences.

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One of the differences we observed was in the number of vomiting episodes. Children aged 6-12 were more likely to experience vomiting and had more frequent vomiting episodes than infants. However, in contrast, severe dehydration was more commonly present in children under one year of age. This is a clinically meaningful finding and can be explained by the physiologic vulnerability of infants, who are more susceptible to fluid loss and dehydration due to their limited compensatory mechanisms and higher body water content.5

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While many clinical features did not differ significantly between stool erythrocyte groups, the study also showed that the number of RBCs in stool remained associated with certain clinical manifestations. Patients with numerous erythrocytes in the stool had more frequent diarrheal episodes and were more likely to present with grossly visible blood in the stool and tenesmus. These findings are consistent with the understanding that the presence of stool erythrocytes may indicate intestinal mucosal inflammation or an invasive infection, which can lead to more severe gastrointestinal symptoms.6

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Although most inflammatory markers were not consistently associated with the overall clinical severity of diarrheal diseases, some were. Patients with higher CRP levels had a higher fever score. Those with elevated erythrocyte sedimentation rates had more diarrheal episodes than those with normal rates. Children with lymphopenia had more vomiting episodes than those with a normal lymphocyte count. These results suggest that inflammatory markers reflect aspects of the clinical presentation of diarrheal diseases, even if they do not directly correlate with overall disease severity.4,7,8

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Taken together, our findings suggest that while inflammatory markers and stool findings are not uniformly reliable indicators of disease severity, they still play an important role in the clinical evaluation of hospitalized children with diarrheal illnesses. In clinical practice, these laboratory parameters are frequent determinants of hospitalization, further monitoring, and initiation of empiric antimicrobial medications.

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This study has several limitations. Firstly, it was a retrospective hospital-based study, which may limit the generalizability of the findings to outpatient populations. Second, the study included only hospitalized children, who may represent more severe cases of diarrheal illnesses. Finally, laboratory testing was performed as part of routine clinical care; therefore, not all patients may have been tested at the same stage of the illness.

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Despite these limitations, this study provides useful insights into the relationships among clinical features, inflammatory markers, and stool findings in hospitalized pediatric patients with acute diarrheal illness. A better understanding of these relationships may help clinicians interpret laboratory results more appropriately and make more informed clinical decisions.