Clinical Features and Role of Viral Isolates from Stool Samples of Intussuception in Children

Abstract

PurposeTo detect major acute gastroenteritis virus (rotavirus, norovirus, astrovirus, and enteric adenovirus) and non-enteric type of adenovirus (AdV) in the stools of intussusception patients and to investigate the clinical role of detected viruses.MethodsFrom March 2012 to February 2013, major acute gastroenteritis virus and non-enteric type of AdV were isolated from stool samples that collected from 44 patients treated for intussusception in Chungnam National University Hospital. Patients were divided according to age and isolated virus.ResultsVirus was detected in 28 (63%) stool specimens. The virus detection rate was significantly lower in patients aged under 12 months (p = 0.04). Twenty-two patients (78.6%) had non-enteric adenovirus, 4 (14.3%) had norovirus, 1 (3.6%) had sapovirus, and 1 (3.6%) had astrovirus. AdV subgroup C (AdV 1, 2, 5, and 6) comprised the majority with 20 cases (90.9%). A monthly increment-and-decrement pattern of intussusception was similar to that of viral detection in the stool samples. Enema reductions were successful in 39 patients and surgical manual reductions were performed in 5 patients. Virus was detected in 24 patients (61.5%) of enema reduction group and 4 patients (80.0%) of surgical manual reduction group. All of the detected viruses were non-enteric adenovirus subgroup C (AdV 1, 5, and 6) in surgical reduction patients.ConclusionsThe virus detection rate was high in the stools of intussusception patients. The pattern of seasonal intussusception occurrence rate was parallel with seasonal these viral detection rate in the stool samples. These findings suggest that viral infection plays an important role in the development of intussusception and further research is warranted.

Epidemiological Correlation between Fecal Adenovirus Subgroups and Pediatric Intussusception in Korea

“…Several other studies have shown that adenoviruses are the viruses predominantly detected in intussusception ( 3 10 11 12 17 18 19 ). In this study, adenoviruses were the pathogens predominantly associated with intussusception, and were detected significantly more often in patients with intussusception than in the controls (42.1% vs. 12.3%, P < 0.001) ( Table 2 ).…”

“…Our results show that 96.3% (51/53) of the adenovirus associated with intussusception were NEAds. Intussusception has been particularly associated with adenoviral types 1, 2, 5, and 6, all belonging to NEAd subgroup C ( 3 19 29 30 ). In our adenoviral subgroup analysis, the predominant subgroup was also adenoviral subgroup C, and 45.1% (23/51) of the NEAds detected were subgroup C in the NEAd-positive patients with intussusception.…”

“…The family Adenoviridae has been considered the predominant viral pathogens involved in the disease in recent decades. Among the Adenoviridae , nonenteric adenoviruses (NEAds) have been demonstrated in 20%–70% of cases of idiopathic intussusception in previous studies ( 3 10 12 18 19 ).…”

Human Astroviruses

“…Finally, the relationship of HAstV infection to the etiology of intussusception in children has also been studied. Although with less frequency than rotavirus, norovirus, and adenovirus infection, HAstV infection has also been identified as a potential risk factor for intussusception in infected children (101)(102)(103).…”

X-linked severe combined immunodeficiency due to a novel mutation complicated with hemophagocytic lymphohistiocytosis and presented with invagination: A case report

“…Although the pathogenic mechanism of intussusception without leading points has not yet been clarifi ed, its major cause is suggested to be swelling and lymph node hyperplasia of Peyer's patch in the ileum secondary to infection [8]. Viral infections play a pivotal role in the etiology of invagination [9]. Invagination was seen after prolonged diarrhea in presented patient and any etiologic agent, such as adenovirus and rotavirus, was not detected.…”