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Diarrhoea in Swedish infants. Aetiology and clinical appearance
Insights
Rotavirus was the most common cause of gastroenteritis in children, identified in 58% of cases. Bacterial pathogens were less frequent and associated with bloody stools, while rotavirus caused more vomiting and dehydration.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Gastroenteritis is a significant cause of childhood illness.
- Identifying causative agents is crucial for effective treatment and public health strategies.
Purpose of the Study:
- To investigate the etiological agents of gastroenteritis in hospitalized children.
- To correlate clinical symptoms with specific pathogens.
- To assess the need for intravenous therapy and antibiotics.
Main Methods:
- Clinical examination and disease course monitoring of 95 children with gastroenteritis.
- Stool specimen analysis using routine bacteriology.
- Rotavirus identification via immune-electrophoresis.
- Comparison with 53 age- and sex-matched healthy controls.
Main Results:
- Rotavirus was detected in 58% of patients; bacterial pathogens (Campylobacter, E. coli, Yersinia, Salmonella) were found in fewer cases (11% combined).
- Bacterial infections were linked to macroscopic blood in stools.
- Vomiting, fever, watery diarrhea, and dehydration were more common with rotavirus.
- 40% of patients had clinical dehydration; only 11% required IV therapy, and 4% received antibiotics.
Conclusions:
- Rotavirus is the predominant cause of pediatric gastroenteritis in this cohort.
- Clinical presentation can help differentiate viral from bacterial etiologies.
- Intravenous therapy and antibiotics are infrequently required, suggesting a need for judicious use.
Abstract:
Ninety-five children with gastroenteritis admitted at the Department of Paediatrics, Malmö General Hospital, Malmö, Sweden, starting November 1978 through October 1979 were studied. Patients were examined clinically and the course of their disease was followed. Stool specimens from all patients were analysed by routine bacteriology and rotavirus identification was done by immune-electroos-mophoresis. Fifty-eight per cent of patients had rotavirus. Campylobacter was found in 6%, enteropathogenic E. coli in 2%, Yersinia enterocolitica in 2% and Salmonella in 1% of patients. Stool specimens from 53 healthy children matched for sex and age served as controls for bacterial pathogens. All were negative. Forty per cent of patients presented with a clinical dehydration, but only 11%-half of them with bacterial enteropathogens-needed i.v. therapy and 4% required antibiotic treatment. Median time for hospitalization was three days. Vomiting, fever, watery diarrhoea and initial clinical dehydration were more commonly associated with rota virus infection. Macroscopic blood in stools was restricted to patients with bacterial aetiology.