Is there any difference between the symptomatology and clinical findings of viral agents causing dehydration?

BACKGROUND

Acute gastroenteritis is responsible for dehydration in many children. The viruses like rotavirus, norovirus, and adenovirus are considered the main causative agents of gastroenteritis. The goal of this study is the evaluation of the symptoms, clinical findings and hospitalization requirements in pediatric patients with dehydration secondary to viral gastroenteritis.

METHODS

The distribution of age, symptoms, clinical and laboratory findings and hospitalization requirements of 156 viral acute gastroenteritis patients with moderate dehydration were evaluated retrospectively. Patients were between 3 months to 16 years of age (mean: 38.7 months). The patients were categorized into four groups according to etiological agents as rotavirus, norovirus, adenovirus, and mixed infections for the comparison of symptoms, clinical characteristics, laboratory results, seasonal distribution, treatment requirements, hospitalization unit, and hospitalization period. Age groups were categorized as 0-24 months, 25-72 months, and >72 months. Clinical characteristics of patients were analyzed for hospitalization period as <24 hours, and ≥24 hours.

RESULTS

Moderate-degree dehydration was detected in 156 patients with acute gastroenteritis (156/278) caused by rotavirus (60.5%), norovirus (58%) and adenovirus (42%) respectively. The common symptoms of all patients were vomiting, diarrhea, abdominal pain and malaise, although fever was seen mostly in the patients of rotavirus. Aspartat aminotransferase (AST) was elevated in rotavirus gastroenteritis (11.5%) more than norovirus (5.4%) and adenovirus (0.8%) infections. Elevated blood urea nitrogen (BUN) levels (>20 mg/dL) were shown in 79.3%, of patients especially in rotavirus (43.8%).

CONCLUSIONS

The main agents of acute gastroenteritis which caused dehydration were norovirus and rotavirus in our patients. Rotavirus was detected in most of the hospitalized patients with severe symptoms. AST was prominently elevated in rotavirus gastroenteritis. The clinical characteristics and some laboratory findings including hyperglycemia, leukocytosis, and elevated AST may be helpful in differentiating rotavirus from norovirus gastroenteritis. BUN level was insignificantly elevated in patients with rotavirus.