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Is there any difference between the symptomatology and clinical findings of viral agents causing dehydration?
Suat Biçer1, Defne Çöl2, Öznur Küçük2
1Department of Child Health and Pediatrics, Faculty of Medicine, Yeditepe University, Istanbul, Turkey - suat.bicer@yeditepe.edu.tr.
Insights
Viral gastroenteritis causes dehydration in children, with rotavirus and norovirus being primary culprits. Rotavirus infections often present with more severe symptoms and elevated AST levels, aiding in differentiation.
Area of Science:
- Pediatrics
- Infectious Diseases
- Gastroenterology
Background:
- Acute gastroenteritis is a significant cause of dehydration in pediatric populations.
- Rotavirus, norovirus, and adenovirus are the predominant viral agents responsible for pediatric gastroenteritis.
- Understanding the clinical spectrum and hospitalization needs is crucial for managing dehydration.
Purpose of the Study:
- To evaluate symptoms, clinical findings, and hospitalization requirements in children with moderate dehydration due to viral gastroenteritis.
- To compare clinical characteristics and laboratory findings among different viral etiologies.
- To identify potential markers for differentiating viral gastroenteritis subtypes.
Main Methods:
- Retrospective analysis of 156 pediatric patients (3 months-16 years) with moderate dehydration from viral acute gastroenteritis.
- Categorization of patients by etiological agents: rotavirus, norovirus, adenovirus, and mixed infections.
- Comparison of symptoms, clinical characteristics, laboratory results, and hospitalization data across age and etiological groups.
Main Results:
- Rotavirus (60.5%), norovirus (58%), and adenovirus (42%) were identified as causative agents.
- Common symptoms included vomiting, diarrhea, abdominal pain, and malaise; fever was more frequent with rotavirus.
- Elevated AST levels were more common in rotavirus gastroenteritis (11.5%) compared to norovirus (5.4%) and adenovirus (0.8%).
- Elevated BUN levels (>20 mg/dL) were observed in 79.3% of patients, particularly with rotavirus (43.8%).
Conclusions:
- Norovirus and rotavirus are the primary viral agents causing dehydration in pediatric patients.
- Rotavirus is associated with more severe symptoms and hospitalization.
- Elevated AST, hyperglycemia, and leukocytosis may help differentiate rotavirus from norovirus gastroenteritis.
Background:
Acute gastroenteritis is responsible for dehydration in many children. The viruses like rotavirus, norovirus, and adenovirus are considered the main causative agents of gastroenteritis. The goal of this study is the evaluation of the symptoms, clinical findings and hospitalization requirements in pediatric patients with dehydration secondary to viral gastroenteritis.
Methods:
The distribution of age, symptoms, clinical and laboratory findings and hospitalization requirements of 156 viral acute gastroenteritis patients with moderate dehydration were evaluated retrospectively. Patients were between 3 months to 16 years of age (mean: 38.7 months). The patients were categorized into four groups according to etiological agents as rotavirus, norovirus, adenovirus, and mixed infections for the comparison of symptoms, clinical characteristics, laboratory results, seasonal distribution, treatment requirements, hospitalization unit, and hospitalization period. Age groups were categorized as 0-24 months, 25-72 months, and >72 months. Clinical characteristics of patients were analyzed for hospitalization period as <24 hours, and ≥24 hours.
Results:
Moderate-degree dehydration was detected in 156 patients with acute gastroenteritis (156/278) caused by rotavirus (60.5%), norovirus (58%) and adenovirus (42%) respectively. The common symptoms of all patients were vomiting, diarrhea, abdominal pain and malaise, although fever was seen mostly in the patients of rotavirus. Aspartat aminotransferase (AST) was elevated in rotavirus gastroenteritis (11.5%) more than norovirus (5.4%) and adenovirus (0.8%) infections. Elevated blood urea nitrogen (BUN) levels (>20 mg/dL) were shown in 79.3%, of patients especially in rotavirus (43.8%).
Conclusions:
The main agents of acute gastroenteritis which caused dehydration were norovirus and rotavirus in our patients. Rotavirus was detected in most of the hospitalized patients with severe symptoms. AST was prominently elevated in rotavirus gastroenteritis. The clinical characteristics and some laboratory findings including hyperglycemia, leukocytosis, and elevated AST may be helpful in differentiating rotavirus from norovirus gastroenteritis. BUN level was insignificantly elevated in patients with rotavirus.
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