Concomitant rotavirus and Salmonella infections in children with acute diarrhea.
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.
Lan
Wen-Tzong
WT
Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.
Lee
Hung-Chang
HC
Yeung
Chun-Yan
CY
Jiang
Chuen-Bin
CB
Kao
Hsin-An
HA
Hung
Han-Yang
HY
Chiu
Nan-Chang
NC