title: Complications in hospitalized children with acute gastroenteritis caused by rotavirus: a retrospective analysis.
abstract: Acute gastroenteritis (AGE) caused by rotavirus (RV) is a common disease among infants and toddlers, often leading to hospitalization and, in resource-poor countries, to death. However, little is known on specific complications of severe RV-positive (RV+) AGE and on the clinical course in chronically ill children. This was a retrospective analysis of data for children <5 years of age hospitalized due to AGE during six rotavirus seasons in three large German pediatric hospitals. The primary study end point was the incidence and type of complications in RV+ versus RV-negative (RV-) cases. A total of 6,884 episodes of AGE in hospitalized children aged <5 years were included in this analysis. Of the 4,880 stools tested for RV, 2,118 (43.4%) were RV+. Hypernatremia was significantly more common in RV+ AGE (P < 0.001) and was associated with severe disease, need for intensive care treatment, and longer duration of hospitalization. Metabolic disorders, particularly hypoglycemia, were more common in RV+ AGE. In contrast, symptoms such as respiratory infections, neurological, and abdominal symptoms were more common in children with RV- AGE.
  
  
  CONCLUSIONS
  Hypernatremia is a specific complication of RV+ AGE. RV would therefore appear to be the cause of infant toxicosis, the traditional descriptive term for severe dehydration and clinical deterioration following AGE.
authors.affiliation: Prof. Hess Kinderklinik, Klinikum Bremen-Mitte, St. Juergen-Strasse, 28205 Bremen, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Kaiser
authors.forename: Michael
authors.initials: M
authors.lastname: Borte
authors.forename: Klaus-Peter
authors.initials: KP
authors.lastname: Zimmer
authors.forename: Hans-Iko
authors.initials: HI
authors.lastname: Huppertz
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D005260:Female; D005759:Gastroenteritis / Q000150:complications* / Q000821:virology; D006760:Hospitalization; D006801:Humans; D006955:Hypernatremia / Q000209:etiology*; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012400:Rotavirus Infections / Q000150:complications*; D012720:Severity of Illness Index