Rotavirus gastroenteritis complicated with toxic megacolon

Hung, Chia-Wei; Wu, Wei; Wu, Chung‐li

doi:10.1111/j.1651-2227.2009.01444.x

Cited by 6 publications

(6 citation statements)

References 14 publications

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“…Rotavirus infections may also cause viremia and other systemic disorders such as pancreatitis, cerebellitis, systemic inflammatory response syndrome, disseminated intravascular coagulation, toxic megacolon, encephalopathy, and biliary atresia. Extraintestinal manifestations are also reported, but their reasons are unknown [2,3]. Various studies have shown that the percentage of children with laboratory signs of hepatitis, defined as increased serum ALT levels, varies from 15% to 37%, and it is not clear whether this occurs due to a potential hepatotropism, or induction of proinflammatory cytokines caused by viral infection, resulting in hepatocyte necrosis [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Serum transaminase elevation in Patients with rotavirus gastroenteritis

Erdoğan¹,

Yazar²,

Güven³

et al. 2017

Ann Clin Anal Med

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Bu çalışmayı yapmaktaki amacımız rotavirüs akut gastroenteriti ile ortalama indiare skoru arasında ilişkiyi değerlendirmektir. Gereç ve Yöntem: Ocak-Temmuz 2016 tarihleri arasında gastroenterit tanısı alan ve hidrasyon amacıyla hastaneye yatırılan 1 ay-16 yaş arası çocuk hastalar çalışmaya alındı. Rotavirüs pozitif gastroenteriti olan hastalar RPGE, rotavirus negatif gastroenteriti olan hastalar RNGE ve basit cerrahi prosedür için çocuk cerrahisi servisine yatırılan hastalar ise kontrol grubu olarak değerlendirildi. Bulgular: RPGE grubundaki hastaların AST ve ALT ortalamaları, RNGE ve kontrol gruplarının ortalamalarından daha yüksek bulundu(p:0.001; p<0.05). RPGE grubundaki olguların 21'inde (%52.5) sadece AST yüksekliği görülürken, 7'sinde (%17.5) hem AST hem de ALT yüksekliği vardı. RNGE grubundaki olguların ise 9'unda (%15) sadece AST yüksekliği görülürken, 4'ünde (%6.7) hem AST hem de ALT yüksekliği bir arada idi. RPGE ve RNGE grubundaki hastaların CRP ve WBC değerleri, kontrol gruplarındaki hastaların değerlerinden daha yüksek bulundu (p<0.05). RPGE ve RNGE grupları arasında anlamlı bir farklılık yoktu (p>0.05). Gruplar arasında PCT, MPV ve PLT değerleri açısından istatistiksel olarak anlamlı bir farklılık bulunmadı (p>0.05). RPGE grubundaki hastaların skor ortalamaları, RNGE grubunun ortalamalarından daha yüksekti ve bu yükseklik istatistiksel olarak anlamlıydı (p:0.001; p<0.05). Gastroenterit skor düzeyi ile PLT, AST ve ALT düzeyleri arasında pozitif yönlü ve anlamlı bir ilişki bulundu (p<0.05). Tartışma: Bu çalışma ile rotavirüs gastroenteritlerinin serum transaminaz artışı ile ilişkili olduğunu saptadık ve transaminaz yüksekliği olan akut gastroenteritli çocuk hastalarda rotavirüs enfeksiyonun hatırlanması gerektiğini vurgulamak istedik.

show abstract

Section: Introductionmentioning

confidence: 99%

Serum transaminase elevation in Patients with rotavirus gastroenteritis

Erdoğan¹,

Yazar²,

Güven³

et al. 2017

Ann Clin Anal Med

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“…Further etiological factors include ischemic colitis, 31 Behçet's disease, 32 and malignancies like colonic lymphoma 33 and Kaposi's sarcoma. There have been case reports of aspergillosis, 34 collagenous colitis, 35 and rotavirus 36 involved in toxic megacolon. Toxic colonic dilatation may also accompany hemolytic-uremic syndrome (HUS) caused by E. coli O157.…”

Section: Etiologymentioning

confidence: 97%

“…Antibiotics of choice are metronidazole or vancomycin. 36 Single case reports describe improvement of toxic megacolon by administration of metronidazole in patients with IBD complicated by C. difficile infection, 81 underlining the importance of early recognition and treatment of C. difficile in toxic megacolon. In toxic megacolon caused by CMV or a complicating superinfection with CMV, administration of gancyclovir is indicated.…”

Section: Medical Therapymentioning

confidence: 98%

Toxic megacolon

and

Baumgart

2012

Inflammatory Bowel Diseases

117

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Toxic megacolon represents a dreaded complication of mainly inflammatory or infectious conditions of the colon. It is most commonly associated with inflammatory bowel disease (IBD), i.e., ulcerative colitis or ileocolonic Crohn's disease. Lately, the epidemiology has shifted toward infectious causes, specifically due to an increase of Clostridium difficile-associated colitis possibly due to the extensive (ab)use of broad-spectrum antibiotics. Other important infectious etiologies include Salmonella, Shigella, Campylobacter, Cytomegalovirus (CMV), rotavirus, Aspergillus, and Entameba. Less frequently, toxic megacolon has been attributed to ischemic colitis, collagenous colitis, or obstructive colorectal cancer. Toxic colonic dilatation may also occur in hemolytic-uremic syndrome (HUS) caused by enterohemorrhagic or enteroaggregative Escherichia coli O157 (EHEC, EAEC, or EAHEC). The pathophysiological mechanisms leading to toxic colonic dilatation are incompletely understood. The main characteristics of toxic megacolon are signs of systemic toxicity and severe colonic distension. Diagnosis is made by clinical evaluation for systemic toxicity and imaging studies depicting colonic dilatation. Plain abdominal imaging is still the most established radiological instrument. However, computed tomography scanning and transabdominal intestinal ultrasound are promising alternatives that add additional information. Management of toxic megacolon is an interdisciplinary task that requires close interaction of gastroenterologists and surgeons from the very beginning. The optimal timing of surgery for toxic megacolon can be challenging. Here we review the latest data on the pathogenesis, clinical presentation, laboratory, and imaging modalities and provide algorithms for an evidence-based diagnostic and therapeutic approach.

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“…In general G1 through G4 and G9 are the most common types causing human infection [5]. A variety of diseases have been found to be associated with rotavirus [6,7]. Detection of rotavirus antigen and/or RNA in the central nervous system, heart, liver, testes, kidneys, bladder, liver biopsy from infant with cholestatic disease, respiratory secretions, lung cells, microvasculatures of heart and serum of those patients have provided indirect evidences of rotavirus or its components as a causative agent [6].…”

Section: Introductionmentioning

confidence: 99%

Circulating rotaviral RNA in children with rotavirus antigenemia

Ahmed

Bozdayı

Mitui

et al. 2013

J Negat Results BioMed

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BackgroundRotavirus antigenemia is a common phenomenon in children with rotavirus diarrhea, but information is scarce on aspects of this phenomenon, such as genotype specificity, presence of intact viruses and correlation between genomic RNA and antigen concentration. Such information may help in understanding rotavirus pathogenesis and eventually be useful for diagnosis, treatment and prevention.Methods and findingsSerum samples were collected from children who presented at hospitals with diarrhea. Antigenemia was present in 162/250 (64.8%) samples from children with rotavirus diarrhea. No specific rotavirus genotype was found to be associated with antigenemia. Rotavirus particles could not be found by electron microscopy in concentrated serum from children with high levels of antigenemia. In passaged rotavirus suspension a significant correlation (r = 0.9559; P = 0.0029) was found between antigen level and viral copy number, but no significant correlation (r = 0.001480; P = 0.9919) was found between antigenemia level and viral copy number in serum. When intact rotavirus was treated with benzonase endonuclease, genomic double-stranded (ds) RNA was not degraded, but when sera of patients with antigenemia were treated with benzonase endonuclease, genomic dsRNA was degraded, indicating genomic dsRNA was free in sera and not inside virus capsid protein.ConclusionsAntigenemia is present in a significant number of patients with rotavirus diarrhea. Rotavirus viremia was absent in the children with rotavirus diarrhea who participated in our study, and was not indicated by the presence of antigenemia. The significance of circulating rotavirus antigen and genomic dsRNA in serum of patients with diarrhea deserves further study.

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Rotavirus gastroenteritis complicated with toxic megacolon

Abstract: Toxic megacolon can occur in patients with rotavirus gastroenteritis. An abdominal radiograph should be taken for patients with rotavirus gastroenteritis who have systemic toxicity and persistent abdominal fullness.

Cited by 6 publications

References 14 publications

Serum transaminase elevation in Patients with rotavirus gastroenteritis

Serum transaminase elevation in Patients with rotavirus gastroenteritis

Toxic megacolon

Circulating rotaviral RNA in children with rotavirus antigenemia

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