Palumbo E, Branchi M, Malorgio C, Siani A, Bonora G
Clinica Pediatrica, Ospedale di Sondrio, Italy.
Minerva Pediatr. 2010 Aug;62(4):347-51.
The aim of this paper was to determine the etiology of diarrhea in children with an age <5 years hospitalised for acute enteritis and to evidence the prevalent clinical aspects in correlation of different etiology agents.
A total of 402 children with acute diarrhea were examined between February 2003 and December 2006 in the Paediatric Department, Hospital of Sondrio. Fecal samples were collected and was processed by routine microbiological and biochemical tests. For all patients the clinical signs and symptoms at the admission were evidenced.
The major part of patients (310/402, 77.1%) resulted infected by rotavirus, while among the remain 82 (22.9%) 40 resulted infected by salmonella species and in 42 any bacterial agent was evidenced by microbiological tests. Clinical signs of mild dehydration were observed in 13 children during the hospital stay (all infected by rotavirus), while any case of metabolic acidosis, hypoglycaemia and hypovolemic shock was documented. Elevated serum levels of uric acid were evidenced in 13/302 (4.3%) of patients with rotavirus infection, while only 1/82 (1.2%) children rotavirus negative presented a minimal increase of serum uric acid level.
Our retrospective study confirms the major epidemiological and clinical importance of rotavirus, as the principal etiologic agent in hospitalised children affected by acute diarrhea with an age <5 years. Also, we have evidenced a possible correlation between rotavirus infection and hyperuricemia, probably connected with dehydration.
本文旨在确定因急性肠炎住院的5岁以下儿童腹泻的病因,并阐明不同致病因素相关的常见临床特征。
2003年2月至2006年12月期间,在松德里奥医院儿科对402例急性腹泻儿童进行了检查。采集粪便样本并通过常规微生物学和生化试验进行处理。记录了所有患者入院时的临床症状和体征。
大部分患者(310/402,77.1%)感染了轮状病毒,其余82例(22.9%)中,40例感染了沙门氏菌属,42例经微生物学检测未发现任何细菌病原体。住院期间,13名儿童出现轻度脱水的临床症状(均感染轮状病毒),未记录到任何代谢性酸中毒、低血糖和低血容量性休克病例。13/302(4.3%)感染轮状病毒的患者血清尿酸水平升高,而82例轮状病毒阴性儿童中只有1例(1.2%)血清尿酸水平略有升高。
我们的回顾性研究证实了轮状病毒作为5岁以下急性腹泻住院儿童主要病原体的重要流行病学和临床意义。此外,我们还发现轮状病毒感染与高尿酸血症之间可能存在关联,这可能与脱水有关。