Concomitant Rotavirus and Salmonella Infections in Children with Acute Diarrhea

Lan, Wen-Tzong; Lee, Hung-Chang; Yeung, Chun-Yan; Jiang, Chuen-Bin; Kao, Hsin-An; Hung, Han-Yang; Chiu, Nan-Chang

doi:10.1016/S1875-9572(09)60023-1

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Volume 50, Issue 1 , Pages 8-12, February 2009

Concomitant Rotavirus and Salmonella Infections in Children with Acute Diarrhea

Wen-Tzong Lan
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
Hung-Chang Lee
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Pediatrics, Taipei Medical University, Taipei, Taiwan
- Corresponding author. Department of Pediatrics, Mackay Memorial Hospital, 92 Section 2, Chung-Shan North Road, Taipei 104, Taiwan
Chun-Yan Yeung
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
Chuen-Bin Jiang
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
Hsin-An Kao
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
Han-Yang Hung
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
Nan-Chang Chiu
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan

Received 5 July 2007; received in revised form 7 July 2008; accepted 1 December 2008.

Background and purpose

The incidence of concomitant rotavirus and Salmonella infection has been reported to be 1.3% to 7.4%. We designed this study to compare the clinical manifestations in children infected with rotavirus, Salmonella, or both.

Methods

The medical records of admitted children with acute rotavirus or Salmonella gastroenteritis in 2001 were reviewed. They were divided into group R (rotavirus), group S (Salmonella) and group C (concomitant infection with both). The differences of clinical manifestations and laboratory data among the three groups were analyzed via chi-squared, analysis of variance (ANOVA), Bonferroni and Kruskal-Wallis tests, and odds ratios with 95% confidence intervals (95% CI).

Results

Among the 895 cases reviewed, 550 were group R, 312 group S, and 33 (3.7%) group C. Group C had more vomiting compared with group S (p = 0.0017). Comparing with group R, group C had more prolonged and high fever (≥ 39°C) (p< 0.05), more percentage of green coloration, with mucus and blood contained in the stool (p < 0.001). The C-reactive protein (CRP) value was significantly higher in group C (9.70 ± 11.05 mg/dL) than in group R (1.33 ± 3.62 mg/dL) or S (5.22 ± 6.11 mg/dL) (p < 0.05). Hypokalemia was found most frequently in group C (C: 30.0%, S: 8.8%, R: 7.3%) (p = 0.0026).

Conclusion

Concomitant rotavirus and Salmonella infections accounted for 3.7% of cases in this study. Patients in group C (30.0%) had a significantly higher incidence of hypokalemia than group R (7.3%) or S (8.8%). Group C consisted of 33 cases of the 895 reviewed cases (3.7%). In a child with rotavirus gastroenteritis, concomitant infection with Salmonella should be considered if the child has sustained a high fever (≥ 39°C) for over 4 days and a green stool with mucus and blood.

Key Words: acute gastroenteritis , concomitant infection , rotavirus , Salmonella

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PII: S1875-9572(09)60023-1

doi:10.1016/S1875-9572(09)60023-1