1/14. Rotavirus infection as cause of tacrolimus elevation in solid-organ-transplanted children.Rotavirus (RV) is the most common cause of diarrheal illness in children. We report three solid-organ-transplanted patients in whom RV infection caused increased trough levels of the immunosuppressive macrolide tacrolimus (TAC) by mechanisms that are still under investigation. The virus was detected for longer in the feces of these patients than in infants not receiving immunosuppressive therapy. In association with short-term monitoring of blood trough levels of TAC, the dosage should be reduced early if symptoms of an acute gastroenteritis are present.- - - - - - - - - - ranking = 1keywords = diarrhea (Clic here for more details about this article) |
2/14. Rotavirus and central nervous system symptoms: cause or contaminant? case reports and review.Rotavirus is a common cause of severe gastroenteritis in children. In 2 patients with rotavirus gastroenteritis who developed encephalopathy, rotavirus rna was detected in the cerebrospinal fluid (CSF) by reverse transcription-polymerase chain reaction; in 1 patient, rotavirus rna was detected on 2 occasions 3 weeks apart. There are increasing reports of cases in which patients who have seizures after an episode of rotavirus diarrhea have evidence of rotavirus in their CSF. A search of 2 large hospital discharge databases suggested that seizures are noted as part of the discharge diagnosis in the records of, at most, <4% of patients with rotavirus diarrhea versus 7% of patients with bacterial diarrhea. Although evidence suggesting that rotavirus is a cause of central nervous system sequelae remains inconclusive, the 2 case reports presented in this study further illustrate a possible association. Further study is required to determine whether detection of rotavirus in CSF represents a true pathogen, CSF contamination that occurs at the time of lumbar puncture or in the laboratory, or carriage of rotavirus rna in trafficking lymphocytes.- - - - - - - - - - ranking = 3keywords = diarrhea (Clic here for more details about this article) |
3/14. Infantile acute hemorrhagic edema and rotavirus infection.Infantile acute hemorrhagic edema (AHE) is a benign condition characterized by a dramatic onset of inflammatory edema and ecchymotic purpura in a target or cockade pattern. It is considered an uncommon form of cutaneous vasculitis occurring in children younger than 2 years of age. The outbreak is frequently preceded by an immunization or various infections. We describe an 11-month-old girl with rosette-shaped purpuric plaques on the face and limbs, clinically consistent with a diagnosis of AHE of the skin, associated with fever and diarrhea. Laboratory investigations showed a rotavirus infection, which has not previously been reported in association with AHE of the skin. The disease had a benign course without relapses. Appropriate microbiologic investigations are advisable to confirm the possible etiologic role of rotavirus.- - - - - - - - - - ranking = 1keywords = diarrhea (Clic here for more details about this article) |
4/14. A cluster of rotavirus enteritis in adult transplant recipients.diarrhea following solid organ transplantation is a common side effect of some immunosuppressive agents but can also be caused by many pathogens. An outbreak of rotavirus (RV) enteritis presenting with severe diarrhea in four solid organ recipients was analyzed. The first case was diagnosed in a 6-month-old liver recipient who was prehospitalized on a pediatric ward. Within 1 month, three adult patients (two liver, one renal recipient) presented with enteritis. During diarrhea a significant rise in tacrolimus levels was observed. One patient developed toxic megacolon with ulcerative colitis. Infections were self-limiting but led to secondary infectious complications and prolonged hospitalization. This is the first reported outbreak of RV enteritis in a multiorgan transplant unit involving adult patients. Although no fingerprinting or subtyping of the virus was performed we assume the child was the primary source. In transplant recipients presenting with diarrhea RV infection should be considered.- - - - - - - - - - ranking = 3keywords = diarrhea (Clic here for more details about this article) |
5/14. Rotavirus infection of the oropharynx and respiratory tract in young children.Oropharyngeal aspirates were obtained from 89 infants hospitalized with respiratory illnesses accompanied or not by diarrhea and 33 control patients without the diseases. Rotavirus was detected from 25 of these patients by immunocytology, isolation of the virus in cultures of MA104 cells, or both. None of the control patients gave a positive result. The infection involves squamous cells and globlet cells probably originating from the oropharynx, and ciliated columnar epithelial cells from the respiratory tract. The virus from 2 specimens was propagated by repeatedly passaging in the cultures and found to have characteristic morphology of rotavirus. The electrophoretic patterns of the viral rna extracted from them are closely similar to those obtained with the rotavirus genome extracted from the stool of the same patients. Repeated stool specimens were also obtained, and sera were paired from some of these subjects. All but one of the patients who gave a positive virology for their aspirates also showed a significant rise in the titres of common group A rotavirus antibody, neutralizing antibody against one or more of serotypes of rotavirus, or both. patients who excreted rotavirus in their stools were younger and had significantly lower titres of rotavirus antibodies in their acute sera, than those who shedded the virus in the oropharynx but did not excrete the virus in repeated stool specimens. The prevalence of rotavirus in the oropharyngeal aspirates from these patients surpassed that of adenovirus, respiratory syncytial virus, influenza virus, and herpes simplex virus combined.- - - - - - - - - - ranking = 1keywords = diarrhea (Clic here for more details about this article) |
6/14. Serial observations of chronic rotavirus infection in an immunodeficient child.Chronic rotavirus infection of an infant with severe combined immunodeficiency (SCID) was studied by virological examinations in association with long-term observation of his symptoms and immune status. During eleven months of hospitalization, the patient was suffering from incurable severe diarrhea with persisting excretion of rotaviruses detected by electron microscopy and the reversed-passive hemagglutination (R-PHA) test and had transient hepatitis symptom despite multiple administrations of human gammaglobulin and high calorie fluids. The detected viruses were morphologically recognized as rotavirus with double capsid structure. Polyacrylamide gel electrophoretic (PAGE) analysis of their genomic RNAs showed the long electropherotype of group A virus with abnormal migration profiles changing considerably from the early to the late phase of illness: (1) The 11th segment became undetectable; (2) the molecular weight of the 6th segment slightly increased; (3) seven to fourteen extra segments appeared; and (4) PAGE patterns of viral genomic RNAs changed every three or four months. These findings suggest that chronic infection with rotavirus accompanied the generation of extra viral genomic segments and their unusual assortments in an immunodeficient host.- - - - - - - - - - ranking = 1keywords = diarrhea (Clic here for more details about this article) |
7/14. Enteroinvasive escherichia coli severe dysentery complicated by rotavirus gastroenteritis.Enteroinvasive escherichia coli (EIEC) is an important agent of pediatric diarrhea and dysentery in developing countries. We report a life-threatening severe dysentery case due to EIEC in a malnourished 4-month-old male, native Indian infant co-infected with rotavirus. The severe gastrointestinal bleeding anemia and hypovolemic shock was successfully treated with IV blood transfusions, rehydration and antibiotic therapy.- - - - - - - - - - ranking = 1keywords = diarrhea (Clic here for more details about this article) |
8/14. First detection of group C rotavirus in patients with gastroenteritis in slovenia.Group C rotaviruses are associated with sporadic gastroenteritis and outbreaks of diarrhea in children and adults worldwide. Three cases with group C rotavirus infection are described, and the molecular characterization of the gene for the major capsid protein VP6 is reported. patients described in this report were 10 years old or more and had mild to moderate clinical symptoms. A high nucleotide (>98%) and amino acid (100%) identity was observed among all three isolated Slovenian group C rotavirus strains. The similar identity is confirmed of Slovenian strains with other human group C rotavirus isolates, which were seen to cluster separately from the animal group C rotavirus isolates by a phylogenetic analysis. This is the first report of group C rotavirus detection in slovenia.- - - - - - - - - - ranking = 1keywords = diarrhea (Clic here for more details about this article) |
9/14. Pneumatosis intestinalis in two infants with rotavirus gastroenteritis.Pneumatosis intestinalis is uncommon in children other than in the premature infant with necrotizing enterocolitis (NEC). We recently observed pneumatosis intestinalis in two infants with rotavirus gastroenteritis. Both children prior to the onset of acute vomiting and diarrhea were healthy and thriving with no evidence of any underlying illness. The disease and the pneumatosis intestinalis observed in the infants presented in this paper responded well to supportive and conservative medical management. The association of pneumatosis intestinalis in otherwise healthy children with acute rotavirus gastroenteritis has not been previously described.- - - - - - - - - - ranking = 1keywords = diarrhea (Clic here for more details about this article) |
10/14. Group C rotavirus infections in patients with diarrhea in thailand, nepal, and england.Atypical rotavirus obtained from fecal specimens of six patients with diarrhea from thailand, nepal, and england were characterized by using polyacrylamide gel electrophoresis and immune electron microscopy. The electropherotypes were characteristic of the porcine reference group C rotavirus strain but demonstrated considerable strain-to-strain variation. Human convalescent group C sera had a high titer (1:320) when tested against the human isolates and a low titer (1:40) when tested against a porcine reference strain (Cowden). When porcine antiserum (Cowden) was tested against the human isolates, the titers ranged from 1:40 to 1:320, indicating significant antigenic diversity between strains. Group C rotavirus appears to have a worldwide distribution as an agent associated with diarrhea in children and adults.- - - - - - - - - - ranking = 6keywords = diarrhea (Clic here for more details about this article) |
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