title: Concomitant rotavirus and Salmonella infections in children with acute diarrhea.
abstract: OBJECTIVE
  The incidence of concomitant rotavirus and Salmonella infection has been reported to be 1.3% to 7.4%. We designed this study to compare the clinical manifestations in children infected with rotavirus, Salmonella, or both.
  
  
  METHODS
  The medical records of admitted children with acute rotavirus or Salmonella gastroenteritis in 2001 were reviewed. They were divided into group R (rotavirus), group S (Salmonella) and group C (concomitant infection with both). The differences of clinical manifestations and laboratory data among the three groups were analyzed via chi-squared, analysis of variance (ANOVA), Bonferroni and Kruskal-Wallis tests, and odds ratios with 95% confidence intervals (95% CI).
  
  
  RESULTS
  Among the 895 cases reviewed, 550 were group R, 312 group S, and 33 (3.7%) group C. Group C had more vomiting compared with group S (p = 0.0017). Comparing with group R, group C had more prolonged and high fever (> or = 39 degrees C) (p < 0.05), more percentage of green coloration, with mucus and blood contained in the stool (p < 0.001). The C-reactive protein (CRP) value was significantly higher in group C (9.70 +/- 11.05 mg/dL) than in group R (1.33 +/- 3.62mg/dL) or S (5.22 +/- 6.11 mg/dL) (p < 0.05). Hypokalemia was found most frequently in group C (C: 30.0%, S: 8.8%, R: 7.3%) (p = 0.0026).
  
  
  CONCLUSIONS
  Concomitant rotavirus and Salmonella infections accounted for 3.7% of cases in this study. They had higher CRP as well as incidence of hypokalemia [corrected] In a child with rotavirus gastroenteritis, concomitant infection with Salmonella should be considered if the child has sustained a high fever (> or = 39 degrees C) for over 4 days and a green stool with mucus and blood.
authors.affiliation: Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Wen-Tzong
authors.initials: WT
authors.lastname: Lan
authors.forename: Hung-Chang
authors.initials: HC
authors.lastname: Lee
authors.forename: Chun-Yan
authors.initials: CY
authors.lastname: Yeung
authors.forename: Chuen-Bin
authors.initials: CB
authors.lastname: Jiang
authors.forename: Hsin-An
authors.initials: HA
authors.lastname: Kao
authors.forename: Han-Yang
authors.initials: HY
authors.lastname: Hung
authors.forename: Nan-Chang
authors.initials: NC
authors.lastname: Chiu