소아 로타바이러스 감염에서 나타나는 호흡기 침범 양상의 임상적 중요성

Abstract

Purpose: Respiratory involvement of rotavirus (RV) infection has been reported but its clinical implication has not well elucidated and there is no domestic report for it in the era of RV vaccination. I did this study to know its update clinical features and significance. Methods: I collected the clinical informations of 65 cases of RV gastroenteritis patients who had been admitted at the Department of Pediatrics, Yogin Severance Hospital from January 2012 to December 2015. RV infection was established by immunochromatographic assay for the RV antigen in the stool. The patients with respiratory manifestation (RM) and without RM were designated to group A and group B, respectively. Both groups were investigated and compared with each other by clinical parameters. Results: Group A were 13 cases (20%) and eleven cases of them (84.6%) were found from March to May. RM were cough (100%), rhinorrhea (84.6%), grunting respiration (76.9%), abnormal finding(s) on plain chest X ray (76.9%), rale (61.5%), decreased breathing sound (38.5%). There were 8 cases (61.5%) of pneumonia. The admission duration of group A was longer than that of group B (4.0±0.2 days for group A vs. 2.8±1.2 days for group B, P =0.015). When compared with group B, group A was younger (29.5±18.7 months old for grup A vs. 54.8±42.7 months old for group B, P =0.042) and had patients composition with higher proportion of 3 and under years old (76.9% for group A vs. 40.4% for group B, P =0.028). Group A showed higher mean total leukocyte counts ( P =0.018), platelet counts ( P <0.001), erythrocyte sedimentation rate ( P =0.011), and serum mean potassium level ( P =0.008) than group B. Duration and severity of fever, vomoting, diarrhea and other biochemical and urinary findings were not significantly different between two groups. Conclusion: Respiratory manifestation is not rare in childhood RV infection. It has a bad influence on the prognosis and is more common in 3 and under years old children and spring. That should be keep in mind of physicians who care the patients with RV infection.