Differences in the clinical and radiologic patterns of rotavirus and non-rotavirus necrotizing enterocolitis.
We analyzed retrospectively 32 successive infants who developed necrotizing enterocolitis (NEC), 13 with rotavirus (RV) infection (RV+) and 19 RV-negative (RV-). All patients showed at least pneumatosis intestinalis. All patients except one had risk factors for perinatal asphyxia. Our study demonstrated significant differences between RV+ NEC and RV- NEC cases: RV+ NEC infants had a higher birth weight and were born at a later gestational age. Oral feeding was started earlier and symptoms developed later and more insidiously in RV+ patients than in RV- NEC babies. Radiology revealed a less severe and more distal colon involvement in RV+ NEC infants, whereas the RV- NEC patients mostly had small intestinal or ileocecal changes and more frequent complications of pneumoportogram and intestinal perforations. These latter infants often had a rapidly deteriorating clinical course; 84% needed surgical treatment. In conclusion RV may be a cause of NEC in susceptible infants. Historic and clinical data and a more distal colonic pneumatosis allow a differentiation of RV+ NEC from other forms of NEC.
Keller
K M
KM
Johannes Gutenberg-University, Department of Pediatrics, Mainz, Germany.
Schmidt
H
H
Wirth
S
S
Queisser-Luft
A
A
Schumacher
R
R
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001724:Birth Weight; D003106:Colon / Q000000981:diagnostic imaging; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011006:Pneumatosis Cystoides Intestinalis / Q000000981:diagnostic imaging / Q000382:microbiology / Q000628:therapy; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D012400:Rotavirus Infections / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents