Rotavirus gastroenteritis. Clinical and laboratory features and use of the Rotazyme test

Clinical and laboratory features of 86 infants admitted with diarrhea and dehydration were evaluated prospectively. Human rotavirus (HRV) infection was documented in 35 infants (41%) by the Rotazyme test. Those with HRV gastroenteritis (HRV+ group) had a shorter duration of diarrhea prior to admission, more severe dehydration on presentation, and a longer hospital course than the HRV-negative (HRV-) group. Vomiting, fever, upper respiratory tract symptoms, otitis media, and cough were present in equal numbers of infants in both groups. The HRV+ infants had lower serum bicarbonate and higher serum albumin, alanine aminotransferase, aspartate aminotransferase, and uric acid concentrations than did the HRV- infants. Serum uric acid levels greater than 10 mg/dL (590 mumol/L) were present in 69% of HRV+ vs 29% of HRV- infants. The Rotazyme test was found to be a valuable tool in diagnosis; testing on two days increased the yield from 74% to 97% of all infants finally diagnosed as HRV+. The optimal time for testing was within the first five days of illness.