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Background
Rotaviral infection is the most common cause of gastroenteritis in young children. Although rotavirus infection has a high morbidity and mortality rate in animals, in most cases in the United States the disease appears to be self-limited in humans though often requiring hospitalization because of dehydration, electrolyte imbalances, and the young age of the patients.
EPIDEMIOLOGY CHARACTERIZATION INCIDENCE Most common cause of gastroenteritis in children younger than the age of 5 Most common in fall and winter
LABORATORY/RADIOLOGIC CHARACTERIZATION LATEX AGGLUTINATION Comparison of latex agglutination with enzyme immunoassay for detection of rotavirus in fecal specimens.
Raboni SM, Nogueira MB, Hakim VM, Torrecilha VT, Lerner H, Tsuchiya LR.
Laboratory of Virology, Clinical Hospital of Federal University of Parana, Curitiba, Brazil.
Am J Clin Pathol 2002 Mar;117(3):392-4 Abstract quote Human rotaviruses are the most important etiologic agents of acquired diarrhea in infants and young children worldwide. Early diagnosis is essentialfor effective patient treatment. The latex agglutination (LA) assays for rotavirus diagnosis are rapid, inexpensive, and the most widely used to screen specimens. The performance of the LA Rotagen (Biokit S.A., Barcelona, Spain) was evaluated for rotavirus detection infecal samples of outpatients with acute gastroenteritis. This assay was compared with the enzyme immunoassay (EIA) EIARA (Bio-Manguinhos, Rio de Janeiro, Brazil).
From January to October 2000, 285 fecal specimens were analyzed. Forty-four samples (15.4%) were reactive, 214 (75.4%) were nonreactive, and 27 (9.5%) were indeterminate by LA. All LA-positive samples were positive by EIA, and 2 LA-negative samples were positive by EIA. Of specimens indeterminate by LA, 67% were positive by EIA. The sensitivity, specificity, and accuracy of LA were 69%, 100%, and 93%, respectively.
These results indicate that assay is as sensitive and specific as the EIA, and it could be applied on a large scale for screening stool specimens in suspected rotavirus diarrhea. However, the indeterminate results must be confirmed by other methods, such as EIA.
GROSS APPEARANCE/CLINICAL VARIANTS CHARACTERIZATION General VARIANTS Rotavirus Encephalopathy Arch Dis Child 61:692-694, 1986
Pediatr Infect Dis 11:773-775, 1992
HISTOLOGICAL TYPES CHARACTERIZATION General VARIANTS Histologic distribution of fatal rotaviral infection: An immunohistochemical and reverse transcriptase in situ polymerase chain reaction analysis Hum Pathol 2001:32:216-221
2 cases of fatal rotaviral infection in a 1 year old and a 4 year old
In each case, the illness showed a rapid systemic course dominated by cardiac and central nervous system involvement; in one case, rotaviral infection was documented by stool culture
Viral RNA was localized by reverse transcriptase in situ polymerase chain reaction to the mucosal cells of the small and large intestine and to many other tissues, including the heart and central nervous system, where it was noted in the endothelial cells of the microvasculature
Immunohistochemical analysis for the virus showed an identical histologic distribution in the intestinal epithelial cells and the systemic microvasculature
Conclusion:
Rotaviral infection can lead to a fatal disseminated infection in humans and the mechanism of this complication is based on a diffuse endothelialitis and concomitant tissue damage.JAMA 6:1371-1376, 1998
Last Updated 3/18/2002
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