1. ¹Bone Marrow Transplant Unit, Christie Hospital NHS Trust, Manchester, UK
2. ²Health Protection Agency Regional Laboratory, Manchester, UK
3. ³Health Protection Agency Regional Laboratory, Bristol, UK
4. ⁴Bone Marrow Transplant Unit, Royal Hospital for Children, UBHT NHS Trust, Bristol, UK

Correspondence: Dr E Liakopoulou, Bone Marrow Transplant and Adult Leukaemia Unit, Christie Hospital NHS Trust, Wilmslow Road, Withington, Manchester M20 2TG, UK. E-mail: Effie.Liakopoulou@christie-tr.nwest.nhs.uk

Received 17 January 2005; Accepted 2 July 2005; Published online 22 August 2005.

Abstract

Infective diarrhoea is common among allogeneic stem cell transplant (SCT) recipients, frequently caused by viruses and may be difficult to differentiate from acute graft-versus-host disease (GVHD). Viral pathogens may directly or indirectly impact upon transplant-related mortality. Rotavirus is one of the most common causes of diarrhoea worldwide, but one of the least studied causes of diarrhoea post SCT. In this retrospective study we describe 21 cases of confirmed rotavirus infection in allogeneic SCT recipients. Most of these cases may occur in clusters during the winter and spring period. Symptoms of rotaviral infection were diarrhoea (95%), vomiting (62%), abdominal pain (38%), weight loss and loss of appetite in 38 and 29% of the cases, respectively. Possible extraintestinal manifestations of rotavirus infection were observed. The duration of the symptoms in this series ranged from 4 days to 4 months with median of 15 days. Patients with rotavirus infection were invariably lymphopenic and/or on immunosuppression for GVHD. Of the patients diagnosed with rotavirus, 86% required hospitalisation. In 57% of the cases, other viral pathogens were isolated near to the rotavirus infection period. Rotavirus infection is an important cause of prolonged diarrhoea post SCT, causing significant morbidity and frequently requiring hospitalisation.