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Clinical features of acute gastroenteritis associated with rotavirus, enteric adenoviruses, and bacteria
Insights
This study differentiates pediatric gastroenteritis causes. Rotavirus causes sudden vomiting and fever, while adenovirus leads to prolonged diarrhea, and bacterial infections suggest abdominal pain and bloody stools.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
Background:
- Acute gastroenteritis is a common childhood illness with diverse etiologies.
- Accurate diagnosis is crucial for effective management and preventing complications.
Purpose of the Study:
- To compare clinical and laboratory features of different gastroenteritis pathogens in children.
- To identify distinct clinical patterns for rotavirus, enteric adenovirus, and bacterial infections.
Main Methods:
- Prospective one-year study of hospitalized and outpatient children with acute gastroenteritis.
- Comparison of clinical symptoms and laboratory findings across etiological groups: rotavirus, enteric adenovirus, bacterial, mixed, and non-specific infections.
Main Results:
- Rotavirus gastroenteritis presented with sudden vomiting, fever, dehydration, and a mean diarrhea duration of 5.9 days.
- Enteric adenovirus caused prolonged diarrhea (mean 10.8 days).
- Bacterial infections were indicated by abdominal pain, bloody stools, prolonged diarrhea (mean 14.1 days), leukocytosis, and elevated ESR.
Conclusions:
- Distinct clinical features can guide presumptive diagnosis of rotavirus, adenovirus, and bacterial gastroenteritis in children.
- Clinical presentation patterns are valuable for differentiating common causes of pediatric gastroenteritis.
Abstract:
In a prospective one year study, comprising children with acute gastroenteritis admitted to hospital or treated as outpatients, the clinical and laboratory features of rotavirus diarrhoea (168 cases) were compared with those of enteric adenovirus (32 cases), bacterial (42), mixed (16), and non-specific (135) infections. The rotavirus disease was remarkably consistent, with a sudden onset of vomiting, a high frequency of fever and dehydration, and a mean duration of diarrhoea of 5.9 days. Outpatients excreting rotavirus had a similar but milder illness, mainly on account of less pronounced vomiting. The predominant symptom of enteric adenoviruses was long lasting diarrhoea (mean 10.8 days). Abdominal pain, bloody stools, prolonged diarrhoea (mean 14.1 days), leucocytosis, and a raised erythrocyte sedimentation rate strongly suggested a bacterial aetiology. Mixed infections caused longer lasting diarrhoea (mean 8.0 days) than rotavirus alone, but the severity of the illness was not increased. The clinical features of infection with unidentified pathogens most resembled those of bacterial infections. Respiratory symptoms were not significantly associated with any particular pathogen. Hypernatraemia and complications were uncommon. This study showed that the clinical features of gastroenteritis with rotavirus, enteric adenoviruses, and bacteria each exhibited patterns that could guide the experienced clinician to a presumptive diagnosis.