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Clinical, Laboratory and Epidermiology Feature of Human Rota Virus(HRV) Gastroenteritis.

Journal of the Korean Pediatric Society 1983;26(10):959-966.
Published online October 31, 1983.
Clinical, Laboratory and Epidermiology Feature of Human Rota Virus(HRV) Gastroenteritis.
Bok Hee Oh, Soo Jee Moon, Keun Soo Lee
Department of Pediatrics, College of Medicine, Hanyang University
Human Rota Virus 감염에 의한 설사증의 역학적, 미생물학적, 임상적 고찰
오복희, 문수지, 이근수
한양대학교 의과대학 소아과학교실
Abstract
According to the statistical survey for hospitalized children with acute diarrheal diseases, we have experienced big incidence of acute epidemic gastroenteritis during the months of October and November every year. In order to investigate the nature of such epidemic gastroenteritis 24 inpatients with acute gastroenteritis were selected at random for electron microscopic(E.M.) examination of stool as well as enzyme linked immunosorbent assay (ELISA) and stool culture for bacterial pathogens. For E.M. the stool suspension was placed on the E.M. grid stained and examined at 30,000 to 50,000 magnification for the characteric particles. No growth of pathogenic organism by bacterial culture except one case out of 24 random cases during the epidemic months was reported. From 18(75%) patients out of 24 random cases HRV were detected by E.M. and 20 cases(83%) were HRV positive by ELISA method. All HRV positive cases by E.M. were also HRV positive by ELISA. Only two cases out of 20 ELISA positive cases were negative by E.M. Clinical and laboratory characteristics of 20 proved HRV cases by E.M. or ELISA were as follows. 1) Mean age of HRV positive cases was 11.3±3.1 months ranging from 5 months to 20 months. 2) Eighteen(90%) cases have had URI symptoms as well as gastrointestinal disease. 3) Abrupt onset of vomiting was noted in 16.(80%) cases to precede watery diarrhea, duration of vomiting was 1.8±0.9 days. 4) Low grade fever was noted in 14(70%) cases, average duration of fever was 3.3±0.8 days. 5) Watery diarrhea developed in all cases, average duration of diarrhea was 5.0 ±1.6 days. 6) Mild to moderate isotonic dehydration was seen in 90%. 7) Mean serum CO2 was 14.1±2.8 mEq/L, Na was 138. l±0.4 mEq/L, Cl was 106.8±4.5mEq/L, K was 4.1 土0.4 mEq/L. 8) Peripheral WBC counts were rarely elevated. 9) All cases recovered without apparent sequelae by symptomatic treatments. 10) Mean duration of hospitalization was 5.5±1.5 days ranging from 3 to 10 days. In summery, the diagnosis of HRV gastroenteritis should be entertained in children from 5 to 24 months of age with, a history of vomiting and diarrhea who present in late October and November with low grade fever, mild to moderate isotonic dehydration, a normal WBC counts and no growth, of pathogenic organisms on bacterial culture of stool. The course of HRV gastroenteritis is usually short and vomiting resolve in the first 2 or 3 days, the diarrhea may last up to 7-8 days. Most hospitalized children recovered with in a week of admission. Because the clinical and some laboratory findings of HRV gastroenteritis in children were so characteric that the diagnosis should be entertained by clinical bases before E.M. or ELISA study.
Key Words: Human Rota Virus, Electrone microscope, Enzyme linked immuno-sorbent assay.


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