Detailed clinical history of the duration, frequency, and character of the diarrhea.

Acute diarrhea refers to <14 days of symptoms; it may be further classified as follows:

• Watery diarrhea – Diarrhea with no visible blood
• Invasive (bloody) diarrhea – Diarrhea with visible blood and/or mucus (by history or inspection), commonly accompanied by fever

Persistent diarrhea refers to ≥14 days of symptoms.

Dehydration and electrolyte disturbances — Electrolyte disturbances may include W

Stool potassium losses commonly result in hypokalemia. This most often manifests with muscle weakness; in more severe cases, hypokalemia may be complicated by paralytic ileus and/or arrhythmia.

Malnutrition  associated diarhoea— nutritional evaluation is needed.

The mortality of children with diarrhea and severe malnutrition may exceed 50 percent. In severely malnourished patients, important clinical signs of dehydration may be masked by kwashiorkor and sepsis. Malnutrition is associated with low vitamin A , children with acute or persistent diarrhea can develop eye lesions of vitamin A deficiency and become blind. This is especially a problem when diarrhea occurs during or shortly after measles or in children who are already malnourished.

Central nervous system (CNS) involvement —  These have been described in patients with severe disease due to Shigella and less commonly in systemic Salmonella infection.

The presence of seizures should prompt consideration of hypoglycemia, hyponatremia, and hypernatremia.

Patients with bacterial meningitis and associated diarrhea may also present with seizures.