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Fecal leukocyte frequency in children with acute viral gastroenteritis: a single-center experience
Dilek Konuksever1, Sevinc Puren Yucel Karakaya2
1Ankara Bilkent City Hospital, Pediatrics, Turkish Ministry of Health - Ankara, Turkey.
Insights
Viral gastroenteritis, particularly rota-adenovirus co-infections, shows a high rate of fecal leukocytes. This suggests clinicians should consider viral pathogens when fecal leukocytes are present.
Area of Science:
- Pediatric Gastroenterology
- Virology
- Clinical Microbiology
Background:
- Gastroenteritis is a common pediatric illness.
- Fecal leukocytes are often associated with bacterial infections.
Purpose of the Study:
- Determine the frequency of rotavirus, adenovirus, and co-infections.
- Investigate fecal leukocyte rates in viral gastroenteritis.
Main Methods:
- Retrospective study of pediatric emergency department patients.
- Stool samples tested for rotavirus and adenovirus antigens.
- Fecal microscopy performed on concurrent samples.
Main Results:
- 1,577 patients analyzed; 583 with fecal microscopy.
- Prevalence: Rotavirus 16.4%, Adenovirus 2.9%, Co-infection 1.8%.
- Fecal leukocyte rates: Rotavirus 4.8%, Adenovirus 13.3%, Co-infection 88.9%.
Conclusions:
- High fecal leukocyte rates observed in viral gastroenteritis.
- Rota-adenovirus co-infections show the highest fecal leukocyte rate.
- Clinicians should not solely attribute fecal leukocytes to bacterial pathogens.
Objective:
Our objective was to determine the frequency of rotavirus, adenovirus, and rota-adenovirus co-infections and investigate the fecal leukocyte rate associated with these infections in patients with gastroenteritis.
Methods:
This is a retrospective study. We identified patients who were admitted to the pediatric emergency department with acute gastroenteritis and had their stool samples tested for rotavirus and/or adenovirus antigens. Among them, we determined the individuals who underwent stool microscopy tests on the same day and recorded their results.
Results:
A total of 1,577 patients who underwent testing for rotavirus and/or adenovirus antigens in their stool samples were identified. Among these patients, 583 individuals had concurrent fecal microscopy results. The prevalence of solely rotavirus antigen positivity was 16.4%, solely adenovirus antigen positivity was 2.9%, and rota-adenovirus co-infections were detected in 1.8% of the children. The fecal leukocyte rates in children infected with rotavirus, adenovirus, and rota-adenovirus co-infections were 4.8, 13.3, and 88.9%, respectively.
Conclusion:
The presence of fecal leukocytes was detected at a high rate in cases of viral gastroenteritis, especially in rota-adenovirus co-infections. Therefore, clinicians should not consider only bacterial pathogens in the presence of fecal leukocytes.
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