Diarrhea in children: etiology and clinical aspects

The aim of this paper was to determine the etiology of diarrhea in children with an age <5 years hospitalised for acute enteritis and to evidence the prevalent clinical aspects in correlation of different etiology agents.

A total of 402 children with acute diarrhea were examined between February 2003 and December 2006 in the Paediatric Department, Hospital of Sondrio. Fecal samples were collected and was processed by routine microbiological and biochemical tests. For all patients the clinical signs and symptoms at the admission were evidenced.

The major part of patients (310/402, 77.1%) resulted infected by rotavirus, while among the remain 82 (22.9%) 40 resulted infected by salmonella species and in 42 any bacterial agent was evidenced by microbiological tests. Clinical signs of mild dehydration were observed in 13 children during the hospital stay (all infected by rotavirus), while any case of metabolic acidosis, hypoglycaemia and hypovolemic shock was documented. Elevated serum levels of uric acid were evidenced in 13/302 (4.3%) of patients with rotavirus infection, while only 1/82 (1.2%) children rotavirus negative presented a minimal increase of serum uric acid level.

Our retrospective study confirms the major epidemiological and clinical importance of rotavirus, as the principal etiologic agent in hospitalised children affected by acute diarrhea with an age <5 years. Also, we have evidenced a possible correlation between rotavirus infection and hyperuricemia, probably connected with dehydration.