import json

data = {
 "topic": "Acute Gastroenteritis",
 "slug": "acute-gastroenteritis",
 "category_id": 14932,
 "summary": "Acute gastroenteritis, most often viral in children, causes significant morbidity worldwide through vomiting and diarrhea; management centers on assessing dehydration severity and rehydration, since most cases are self-limited.",
 "written_by": "claude-sonnet",
 "references": [
  {"title": "Kliegman R. Nelson Textbook of Pediatrics 2-Volume Set 22ed 2024", "author": None, "pages": [1796, 2376]},
  {"title": "2021_Fleisher_&_Ludwig's_Textbook_of_Pediatric_Emergency_Medicine.epub", "author": None, "pages": []},
  {"title": "Pediatric Nutrition (Ronald E. Kleinman, Frank R. Greer)", "author": None, "pages": [838]},
  {"title": "Pediatric ICD-10-CM 2023", "author": "American Academy of Pediatrics Committee on Coding and Nomenclature;", "pages": [152]},
  {"title": "Red Book Atlas of Pediatric Infectious Diseases", "author": "American Academy of Pediatrics,Carol J. Baker, MD, FAAP", "pages": [724]},
  {"title": "Caring for the Hospitalized Child", "author": "Section on Hospital Medicine, American Academy of Pediatrics;Jeffrey C. Gershel;Daniel A. Rauch;", "pages": [276, 312]},
  {"title": "Netters Pediatrics (Florin Т., Ludwig St.)", "author": None, "pages": [625]},
  {"title": "Pediatric Nutrition Handbook", "author": "Kleinman, Ronald E.", "pages": [709]}
 ],
 "short": [
  {"title": "In short", "content": (
   "- Gastroenteritis is defined as GI infection/inflammation causing vomiting, diarrhea, or both, with 3 or more loose or watery stools per day\n"
   "- Viruses cause the majority of acute gastroenteritis (AGE) in both developing and developed countries; in the US, norovirus and rotavirus together account for almost 40% of viral AGE\n"
   "- Rotavirus incidence has declined markedly since routine vaccination was introduced; it classically causes voluminous watery diarrhea without blood or leukocytes, mainly affects infants 3-15 months old, peaks in winter, and spreads via the fecal-oral route, surviving for hours on hands and days on surfaces\n"
   "- Adenovirus, sapovirus, astrovirus, parechovirus, and bocavirus together account for another ~30% of viral AGE cases in preschool-age children\n"
   "- In the US, gastroenteritis primarily affects children under 5, with an estimated 21-37 million episodes, about 200,000 hospitalizations, and 300-400 deaths annually; worldwide, diarrheal illness kills an estimated 1.8 million children\n"
   "- Campylobacter jejuni/coli cause acute bacterial gastroenteritis with an average incubation of 3 days (range 1-7); a prodrome of fever/headache/dizziness/myalgias can precede cramping pain and loose or bloody stools, with visible blood appearing in about 15% of cases overall but in more than half of younger children\n"
   "- Hematochezia and high fever in an older child, or a history of travel to a developing country, should raise suspicion for a bacterial etiology rather than viral\n"
   "- Vibrio gastroenteritis typically follows ingestion of raw/undercooked shellfish (oysters, clams, crabs, shrimp), with an incubation period of about 24 hours (range 5-92 hours); people with liver disease, low gastric acidity, or immunodeficiency are more susceptible\n"
   "- No laboratory studies are routinely indicated for typical, mild viral-appearing AGE in an otherwise well child\n"
   "- The severity of AGE is best reflected by the degree of dehydration, which should be assessed at first presentation and reassessed during follow-up to judge the adequacy of rehydration; persistent high fever and lethargy suggest more severe/systemic illness, and rare complications include benign seizures (reported with rotavirus and norovirus) and, very rarely, severe encephalopathy"
  )}
 ],
 "long": [
  {"title": "Definition", "content": (
   "Acute gastroenteritis (AGE) is an infection or inflammation of the gastrointestinal tract characterized by vomiting, diarrhea, or both, with diarrhea typically defined as three or more loose or watery stools in a day."
  )},
  {"title": "Epidemiology", "content": (
   "Gastrointestinal infections, and acute gastroenteritis in particular, cause substantial pediatric morbidity and mortality worldwide, with an estimated 1.8 million childhood deaths attributed to diarrheal illness globally. In the United States, AGE predominantly affects children younger than 5 years, with an estimated 21-37 million episodes, approximately 200,000 hospitalizations, and 300-400 deaths occurring annually. Rotavirus and norovirus are the two leading causes of viral AGE, together accounting for almost 40% of cases in the US; rotavirus incidence has fallen substantially since the introduction of routine rotavirus vaccination. An additional roughly 30% of viral AGE cases in preschool-age children are attributable to adenovirus, sapovirus, astrovirus, parechovirus, and bocavirus. Causes of acute diarrhea vary by geographic location, season, and the host's immunologic status."
  )},
  {"title": "Etiology", "content": (
   "Viruses are the most common cause of AGE in both developing and developed countries. Rotavirus, a 67-nm double-stranded RNA virus with at least eight serotypes, primarily affects infants between 3 and 15 months of age, peaks in incidence during winter, and is transmitted via the fecal-oral route; the virus can survive for hours on hands and for days on environmental surfaces, and children can shed virus in stool for weeks to months after acute infection, contributing to community spread. Among bacterial causes, Campylobacter jejuni (90-95% of Campylobacter cases) and C. coli are common, with C. jejuni and C. coli producing indistinguishable clinical presentations; rarer Campylobacter species (C. lari, C. hyointestinalis, C. upsaliensis) can also cause disease. Noncholera Vibrio species cause gastroenteritis typically following ingestion of raw or undercooked seafood (oysters, clams, crabs, shrimp); wound infections from these organisms can also occur from contaminated seawater or shellfish handling, though person-to-person transmission has not been reported. Individuals with liver disease, low gastric acidity, or immunodeficiency have increased susceptibility to Vibrio infection."
  )},
  {"title": "Clinical features", "content": (
   "Common symptoms of viral AGE are diarrhea and/or vomiting, crampy abdominal pain, and fever, with examination showing pyrexia, tachycardia, and hyperactive bowel sounds; most viral AGE is self-limited in healthy children. Hematochezia and high fever in an older child, or a history of international travel to a developing country, should raise suspicion for a bacterial rather than viral etiology. Campylobacter gastroenteritis has an average incubation period of 3 days (range 1-7 days); about one-third of symptomatic patients experience a prodrome of fever, headache, dizziness, and myalgias, followed 1-3 days later by cramping abdominal pain and loose, watery stools, or less commonly, mucus-containing bloody stools. Blood appears in the stool in approximately 15% of cases overall, typically 2-4 days after symptom onset, but in more than half of younger children. Some patients, most often those aged 6-15 years, do not develop diarrhea at all, with fever as the initial or sole manifestation (most pronounced in patients over 1 year old); 60-90% of older children also report abdominal pain, most frequently periumbilical. Vibrio gastroenteritis from contaminated seafood has an incubation period of approximately 24 hours (range 5-92 hours)."
  )},
  {"title": "Diagnostics", "content": (
   "No laboratory studies are routinely indicated for a typical, well-appearing child with presumed viral AGE. The severity of AGE is best reflected clinically by the degree of dehydration, which should be assessed at the initial encounter and reassessed at follow-up to judge whether rehydration therapy has been effective. Persistent high fever and lethargy are signs that suggest a more severe clinical course or systemic involvement warranting closer evaluation, rather than routine self-limited viral gastroenteritis."
  )},
  {"title": "Differential diagnosis", "content": (
   "Bloody stool, high fever in an older child, or a relevant travel history should shift suspicion toward a bacterial etiology (e.g., Campylobacter) rather than the far more common viral causes. A history of recent shellfish ingestion, particularly raw or undercooked oysters, clams, crabs, or shrimp, points toward Vibrio infection. Underlying conditions such as liver disease, achlorhydria/low gastric acidity, or immunodeficiency should be considered in patients with unusually severe presentations, since these increase susceptibility to certain pathogens like Vibrio."
  )},
  {"title": "Complications", "content": (
   "Most viral AGE in healthy children is self-limited, but complications can occur: benign seizures unrelated to electrolyte imbalance have been reported with rotavirus- and norovirus-induced gastroenteritis, and rare, severe encephalopathies associated with severe diarrheal illness have also been described in surveillance studies. More broadly, dehydration is the central complication driving morbidity and the need for medical intervention in AGE, and its degree should guide the intensity of rehydration and monitoring."
  )}
 ],
 "clinical": [
  {"title": "Approach at the bedside", "content": (
   "In a child presenting with vomiting and/or three or more loose stools per day, the central clinical task is assessing the degree of dehydration, since this - not the specific pathogen - drives management decisions and correlates with illness severity; reassess hydration status at follow-up to confirm rehydration efforts are working. For a well-appearing child with a typical, self-limited-appearing presentation (fever, crampy pain, watery diarrhea, hyperactive bowel sounds, no blood), no laboratory testing is routinely needed and supportive care with attention to rehydration is appropriate.\n\nLook specifically for features that should prompt reconsideration of a bacterial cause and possibly further workup: hematochezia, high fever in an older child, or recent international travel to a developing country. Ask about recent shellfish consumption if the presentation is unusual or severe, since this points to Vibrio, particularly in a patient with underlying liver disease, low gastric acidity, or immunodeficiency who would be more susceptible. Persistent high fever and lethargy are red flags for more severe or systemic illness rather than routine viral AGE and warrant closer evaluation. Counsel families on the expected self-limited course of viral AGE, the importance of monitoring hydration status at home, and when to seek reassessment (worsening dehydration, persistent high fever, lethargy, or blood in the stool)."
  )}
 ]
}

with open("/tmp/age.article.json", "w") as f:
    json.dump(data, f, indent=1)
print("written")