최근 소아 로타바이러스 장염의 임상적 특성

Abstract

Purpose: Rotaviral enteritis is well known as a leading cause of childhood diarrhea. There were a few reports show the change of its clinical findings and those were different from author’s experiences. I intended to investigate the update clinical characteristics of rotaviral enteritis to help the diagnosis and management of patients with diarrhea.

Methods: I studied the medical records of viral enteritis patients who admitted YongIn Severance Hospital. Annual patient numbers of rotaviral enteritis (RV) and non-rota viral enteritis (NRV) were obtained from 2002 to 2006 to know the detection rate of RV. Clinical features such as age distribution, dehydration severity, continual high fever (>38.3 ℃), hospital admission days, electrolyte findings were compared in the RV with NRV patients on 2006. Diagnosis of rotavirus infection was performed with detection of antigen of group A rotavirus using immunochromatograph kit (Dipstick Rota?) in feces. Excel program of MS Office 2003 has been used to investigate the statistical significance.

Result: Rota virus were detected in 26.6% of viral enteritis patients. The percentage of patients from two years up were 66.7%. There were no statistical difference between RV and NRV in terms of mean age (2.4 vs 2.7 years old), hospital stay days (4.4 vs 4.0 days). There were more RV patients than NRV patients with moderate and severe dehydration (56.1% vs 37.3%), continual high fever more than 48 hours (24.4% vs 15.7%), hyponatremia (6.5% vs 2.1%), hypokalemia (9.8% vs 4.3%) (p<0.05).

Conclusion: Over 70% of viral enteritis was not caused by rota virus. So the further causative study for viral enteritis should be done in the future. More than two third of RV patients were detected in the age of two and over years old and more severe clinical features were shown in RV patients. Rota virus should be put into consideration for diarrhea patients with over two years old and more diagnostic approach and supportive care should be done for them.