Rotavirus infection: symptoms

Rotavirus infection has a incubation period, which ranges from 14-16 hours to 7 days (on average, 1-4 days).

There is a typical and atypical rotavirus infection. A typical rotavirus infection, depending on the severity of the leading syndromes, is divided into mild, moderate and severe forms. To atypical refers to the erased (clinical manifestations are weak and short-term) and asymptomatic forms (complete absence of clinical manifestations, but laboratory detect rotavirus and specific immune response). The diagnosis of virus carrying is determined by the detection of rotavirus in a healthy person who did not have any specific changes in dynamics during the examination.

Rotavirus infection usually begins acutely, with a rise in body temperature, typical symptoms of rotavirus infection appear: intoxication, diarrhea and repeated vomiting, which allowed foreign researchers to characterize rotavirus infection as a DFV syndrome (diarrhea, fever, vomiting). These symptoms are noted in 90% of patients; they occur almost simultaneously on the first day of the disease, reaching a maximum severity within 12-24 hours. In 10% of cases, vomiting and diarrhea appear on the 2-3rd day of the disease.

There may also be a gradual onset of the disease, with a slow increase in the severity of the process and the development of dehydration, which often causes late hospitalization.

Vomiting is not only one of the first, but often leading signs of rotavirus infection. Usually it precedes diarrhea or appears simultaneously with it, can be repeated (up to 2-6 times) or multiple (up to 10-12 times or more), lasts for 1-3 days.

The increase in body temperature is moderate: from subfebrile to febrile. The duration of the fever fluctuates within 2-4 days, there are symptoms of rotavirus infection: lethargy, weakness, decreased appetite, down to anorexia.

Intestinal dysfunction proceeds mainly as a gastroenteritis or enteritis, characterized by a liquid, watery, foamy stool of yellow color without pathological impurities. The frequency of defecation more often corresponds to the severity of the disease. With an abundant fluid stool, dehydration may develop, usually I-II degrees. Only in some cases, severe dehydration with decompensated metabolic acidosis is observed, with acute renal failure and hemodynamic disorders possible.

From the very beginning of the disease can be observed abdominal pain. Most often they are mild, persistent, localized in the upper half of the abdomen; in some cases - cramping, strong. When palpating the abdomen, note tenderness in the epigastric and umbilical regions, rough rumbling in the right ileal region. The liver and spleen are not enlarged. Signs of damage to the digestive system persist for 3-6 days.

Part of patients, mainly in young children, develop catarrhal symptoms of rotavirus infection: coughing, runny nose or stuffy nose, rarely - conjunctivitis, catarrhal otitis. On examination, attention is drawn to the hyperemia and granularity of the soft palate, palatine arch, tongue.

The amount of urine in the acute period of the disease is reduced, in some patients there is insignificant proteinuria, leukocyturia, erythrocyturia, and an increase in creatinine and urea in the blood serum. At the onset of the disease, there may be leukocytosis with neutrophilia. In the midst of a swell, followed by leukopenia with lymphocytosis; ESR is not changed. For the coprocytogram is characterized by the absence of signs of a pronounced inflammatory process, while the seeds of starch, undigested fiber, neutral fat are found. The majority of patients with rotavirus infection report a disturbance in the composition of the fecal microflora, primarily a decrease in the content of bifidobacteria, and an increase in the number of opportunistic microbial associations. They reveal signs of lactase deficiency, including acid pH values of feces.

Symptoms of rotavirus infection of a mild form:

• subfebrile body temperature:
• moderate intoxication within 1-2 days:
• infrequent vomiting;
• stool with liquid gruel to 5-10 times a day.

Symptoms of rotavirus infection of a moderate form:

• febrile fever:
• severe intoxication (weakness, lethargy, headache, pale skin):
• repeated vomiting for 1.5-2 days;
• abundant watery stools 10 to 20 times a day;
• dehydration of I-II degree.

Heavy forms of rotavirus gastroenteritis are characterized by a violent onset with an increase in severity of the condition to the 2-4th day of the disease due to significant fluid loss (dehydration of grade II-III), multiple vomiting and countless watery stools (more than 20 times a day). Hemodynamic disturbances are possible.

Complications of rotavirus infection:

• circulatory disorders;
• acute cardiovascular insufficiency;
• acute extrarenal renal failure;
• secondary disaccharidase insufficiency:
• intestinal dysbiosis.

It is necessary to consider the possibility of stratification of secondary bacterial infection, which leads to changes in the clinical picture of the disease and requires correction of the therapeutic approach. In connection with the possibility of developing complications in rotavirus gastroenteritis, high-risk patients are identified, including newborns, young children, elderly, and patients with severe comorbidities. The symptoms of rotavirus infection in people with immunodeficiencies (eg, HIV-infected), who may have necrotic enterocolitis and hemorrhagic gastroenteritis, have been insufficiently studied.

Lethal outcomes are more common in young children with severe immunological deficits and hypotrophy, as well as among elderly patients with severe concomitant pathology (such as atherosclerosis, chronic hepatitis), and in some cases with a mixed infection.

[1], [2], [3], [4], [5]