Septic Shock Secondary to Severe Gastroenteritis Resulting From Sapovirus Infection

Landa, Eric; Javaid, Saad; Won, Jung S; Vigandt, Erika; Caronia, Jonathan; Mir, Parvez; Thet, Zeyar

doi:10.7759/cureus.24010

Cited by 3 publications

(2 citation statements)

References 15 publications

(10 reference statements)

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“…This could be explained by elderly patients commonly either having full recovery due to improved health care systems [ 3 ] or dying from rotavirus gastroenteritis, with cases of significant morbidity where the patient recovers being rare [ 5 ]. Landa et al described a case of sapovirus gastroenteritis causing septic shock in an adult patient [ 9 ]. Similar to our case, the patient was diagnosed with a typically benign pathogen causing profound illness and raised inflammatory markers and required ICU admission.…”

Section: Discussionmentioning

confidence: 99%

Rotavirus Gastroenteritis Leading to Multi-Organ Failure in an Adult

Edwards,

Abasszade,

Nan

et al. 2023

Am J Case Rep

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Patient: Male, 65-year-old Final Diagnosis: Acute kidney injury • myocardial infarction • rotavirus infection Symptoms: Diarrhea • vomiting Clinical Procedure: Intravenous hydration • renal replacement therapy Specialty: General and Internal Medicine Objective: Rare coexistence of disease or pathology Background: Infectious diarrheal illnesses such as rotavirus gastroenteritis are significant contributors to childhood morbidity and mortality, especially in low socio-demographic index regions. Major advances in addressing this issue include sanitation and clean water initiatives, as well as rotavirus immunization. In Australia, a robust vaccination program has significantly reduced childhood rotavirus infections, leading to decreased hospitalizations and mortality. However, cases of adult rotavirus still occur, and although these adult patients usually do not require interventional management, it is possible for them to present critically unwell and require resuscitation. Case Report: A previously well 65-year-old man presented to the Emergency Department febrile and hypotensive with severe diarrhea attributed to rotavirus. Clinically, he presented with mixed hypovolemic and septic shock. Despite initial resuscitation, he had multiple severe acute end-organ complications, secondary to poor perfusion. He acquired an acute kidney injury, type-2 myocardial infarction, and ischemic hepatic injury. The mainstay of management was rapid fluid resuscitation, continuous renal replacement therapy, and monitoring in the Intensive Care Unit; however, it was crucial to empirically treat for other causes of shock. Conclusions: To the best of our knowledge, there is a scarcity of reports documenting the management of severe rotavirus gastroenteritis in adults. We recommend advising elderly patients to avoid contact with individuals with diarrheal illnesses, especially rotavirus gastroenteritis. Clinicians should also promote awareness regarding the potential severity of a disease that is typically managed conservatively, and be aware that intervention can be required in severe gastroenteritis.

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Section: Discussionmentioning

confidence: 99%

Rotavirus Gastroenteritis Leading to Multi-Organ Failure in an Adult

Edwards,

Abasszade,

Nan

et al. 2023

Am J Case Rep

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“…However, serious issues could still arise [10]. Worldwide the incidence of gastroenteritis caused by sapovirus has increased in recent years [23].…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis of sapovirus genetic diversity based on VP1 and NS6-7

Ren,

Xue,

Gao

et al. 2024

Preprint

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A significant foodborne pathogen that causes acute gastroenteritis worldwide is sapovirus. Currently, there have been reports of certain recombinant strains of sapovirus, and the genetic diversity of this virus is continuously increasing. In this study, sapovirus nucleotide sequences with entire VP1 and NS6-7 regions were obtained from GenBank, and phylogenetic analysis and genetic distance calculations were performed to investigate the genetic diversity of the VP1 and NS6-7 regions of this virus. In addition to the 19 known genogroups, a small number of sequences were discovered to be beyond the range of known genogroups and were temporarily divided (Bat NA1-Bat NA3). This was based on the genetic diversity of the entire VP1 region. Based on the VP1 region, 38 key reference sequences were also suggested. Furthermore, for 33 sequences for which the genotyping tool mistyped, the genotype and genogroup information were modified. We also attempted to categorize sapovirus based on the genetic diversity of the nucleotide sequences of NS6-7 region. Phylogenetically, 17 P (polymerase)-groups (GI.P-GIII.P, GV.P-GVIII.P, GX.P-GXIX.P) and one tentative (GNA1.P) were identified based on the genetic diversity of nucleotide sequences in the entire NS6-7 region, and 35 related reference sequences were also suggested. Nine recombinant sequences, including six recombinant genotypes (GI.1[P4], GI.2[P1], GII.4[P1], GII.4[PNA1], GII.6[P2], and GV.5[P3]), were identified by genetic diversity differences between VP1 and NS6-7 of sapovirus. With this approach, sapovirus recombination events may be effectively characterized.

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