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Rotavirus fecal antigen retrieval in infantile intussusception
M A El-Hodhod1, M F Nassar, S Ezz El-Arab
1Department of Pediatrics, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt.
Insights
Natural rotavirus infection in infants with gastroenteritis (GE) does not increase the risk of intussusception. Rotavirus antigen detection rates and disease severity showed no significant association with intussusception in this study.
Area of Science:
- Pediatrics
- Infectious Diseases
- Gastroenterology
Background:
- Intussusception is a serious pediatric surgical emergency.
- The potential link between rotavirus infection and intussusception remains a subject of investigation.
- Understanding causative factors is crucial for prevention and management.
Purpose of the Study:
- To investigate the association between natural rotavirus infection and intussusception in infants.
- To compare rotavirus prevalence in infants with intussusception versus those with uncomplicated acute gastroenteritis.
- To analyze the role of seasonality and severity in rotavirus-associated intussusception.
Main Methods:
- Case-control study comparing 21 infants with intussusception and 40 with acute gastroenteritis.
- Detailed clinical evaluation, stool analysis for rotavirus antigen (ELISA), and imaging (X-ray, ultrasound).
- Assessment of disease severity, including dehydration and need for IV fluids.
Main Results:
- Rotavirus antigen was detected in 47.6% of intussusception cases and 60.0% of uncomplicated gastroenteritis cases.
- No significant difference in disease severity or need for intravenous fluids between the groups.
- Rotavirus-positive intussusception cases showed a seasonal peak in winter months (February, December), unlike the uncomplicated GE group.
Conclusions:
- Rotavirus antigen detection rates in stool do not differ significantly between infants with intussusception and those with uncomplicated gastroenteritis.
- No statistically significant association was found between natural rotavirus infection and the occurrence of intussusception.
- Wild rotavirus infection in gastroenteritis patients does not appear to confer an additional risk for intussusception.
Abstract:
This study was designed to assess the plausibility of an association between natural rotavirus infection and intussusception. It was conducted on 21 infants suffering from acute gastroenteritis (GE) complicated by intussusception who were compared to another 40 age- and sex-matched infants suffering from acute GE characterized by watery nonmucoid diarrhea without surgical complications. All enrolled patients were subjected to detailed history documentation, thorough clinical examination and laboratory investigations, complete stool analysis, and detection of rotavirus antigen in stools using the ELISA technique. Plain abdominal X-ray and ultrasound were also performed. The results of this study revealed 24 positive cases for rotavirus antigen in the stools of the acute uncomplicated GE patients (60.0%), while there were only ten positive cases in the intussusception group (47.6%). No significant difference in severity was detected between the two groups studied, especially in terms of signs of dehydration and need for IV fluids (p > 0.05). Most of the rotavirus positive cases among the intussusception group presented either in February or December (p < 0.05) with no significant seasonal pattern among the acute GE group (p > 0.05). In conclusion, rotavirus antigen retrieval from stools of GE patients complicated with intussusception was not statistically different from those detected among acute uncomplicated GE. Additionally, there was no association between seasonality or severity of rotavirus positive cases in acute GE patients and those with intussusception. It is thus prudent to say that wild rotavirus infection in GE patients does not carry an extra risk for the occurrence of intussusception.
