Rotavirus enteritis in solid organ transplant recipients: an underestimated problem?

Abstract

RV enteritis is a common infection in pediatric solid organ recipients but may also affect adult patients.

Complications in hospitalized children with acute gastroenteritis caused by rotavirus: a retrospective analysis

“…Despite anecdotal evidence [43,44], this study confirms previous findings that RV infection generally does not follow a more severe course in terms of need for intensive care treatment in children with underlying conditions. This is contrary to what one might assume.…”

“…However, the clinical significance of these observations is not yet clear. Severe courses of RV+ AGE have been reported in immunocompromised children and adults [9,36,43,44]. Other complications may result from secondary bacteremia, mostly Gram-negative, probably via mucosal damage as a result of RV+ AGE [1,4,5,21,[25][26][27]29].…”

Rotavirus Infection in Adult Small Intestine Allografts: A Clinicopathological Study of a Cohort of 23 Patients

“…However, rotavirus-specific memory and protective immunity is largely a B cell function because cytotoxic T cell-depleted mice are able to maintain resistance to reinfection (5,6). Adults could, however, be symptomatically infected when immunocompromised, as in the solid-organ transplant context (7)(8)(9). Rotavirus infection in small bowel allografts is increasingly recognized and the importance of recognizing its features, as they differ from cellular rejection, was recently emphasized (2).…”

Background paper to the recommendation for routine rotavirus vaccination of infants in Germany

“…However, chronic diarrhoea and extraintestinal manifestations have been observed, particularly in immunocompromised individuals with conditions such as severe combined immunodeficiency (SCID), acquired immunodeficiency syndrome (AIDS), and DiGeorge syndrome [41,42]. In addition, patients suffering from congenital immunodeficiency or immunosuppression due to bone marrow or solid organ transplantation are at risk for more severe or prolonged RV disease [43,44]. In contrast, several studies have shown that breast feeding can protect against symptomatic RV infection [45,46,47,48].…”