Summary:
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.
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References
Epstein RJ, McDonald GB, Sale GE et al. The diagnostic accuracy of the rectal biopsy in acute graft-versus-host disease: a prospective study of thirteen patients. Gastroenterology 1980; 78: 764–771.
McDonald GB, Shulman HM, Sullivan KM, Spencer GD . Intestinal and hepatic complications of human bone marrow transplantation. Part I. Gastroenterology 1986; 90: 460–477.
McDonald GB, Shulman HM, Sullivan KM, Spencer GD . Intestinal and hepatic complications of human bone marrow transplantation. Part II. Gastroenterology 1986; 90: 770–784.
Martin PJ, Schoch G, Fisher L et al. A retrospective analysis of therapy for acute graft-versus-host disease: initial treatment. Blood 1990; 76: 1464–1472.
Yolken RH, Bishop CA, Townsend TR et al. Infectious gastroenteritis in bone-marrow-transplant recipients. N Engl J Med 1982; 306: 1010–1012.
Blakey JL, Barnes GL, Bishop RF, Ekert H . Infectious diarrhoea in children undergoing bone-marrow transplantation. Aust N Z J Med 1989; 19: 31–36.
Cox GJ, Matsui SM, Lo RS et al. Etiology and outcome of diarrhoea after marrow transplantation: a prospective study. Gastroenterology 1994; 107: 1398–1407.
Estes MK . Rotavirus and their replication. In: Fields BN, Knipe DM (eds). Fields Virology, 2nd edn. Raven Press: New York, 1990, pp 1329–1352.
Troussard X, Bauduer F, Gallet E et al. Virus recovery from stools of patients undergoing bone marrow transplantation. Bone Marrow Transplant 1993; 12: 573–576.
Willoughby RE, Wee SB, Yolken RH . Non-Group A rotavirus infection associated with severe gastroenteritis in a bone marrow transplant patient. Pediatr Infect Dis 1988; 7: 133–135.
Fitts SW, Green M, Reyes J et al. Clinical features of nosocomial rotavirus infection in pediatric liver transplant recipients. Clin Transplant 1995; 9: 201–204.
Herrmann JE, Blackow NR . Rotavirus. In: Mandell GL, Douglas RG, Bennett JE (eds). Principles and Practice of Infectious Diseases, 3rd edn. Churchill Livingstone: New York, 1990, 1234pp.
Leannette EH, Schmidt NJ (eds). Diagnostic Procedures for Viral, Rickettsial and Chlamydial Infections. American Public Health Association: Washington, DC, 1989.
Captanio MA, Greenberg SB . Pneumatosis intestinalis in two infants with rotavirus gastroenteritis. Pediatr Radiol 1991; 21: 361–362.
Yeager AM, Kanof ME, Kramer SS et al. Pneumatosis intestinalis in children after allogeneic bone marrow transplantation. Pediatr Radiol 1987; 17: 18–22.
Kanfer EJ, Abrahamson G, Taylor J et al. Severe rotavirus-associated diarrhoea following bone marrow transplantation: treatment with oral immunoglobulin. Bone Marrow Transplant 1994; 14: 651–652.
Aitken C, Jeffries DJ . Nosocomial spread of viral disease. Clin Microbiol Rev 2001; 14: 528–546.
Kruger W, Stockschlader M, Zander R . Transmission of rotavirus diarrhoea in bone marrow transplantation unit by a hospital worker. Bone Marrow Transplant 1991; 8: 507–508.
Pang XL, Lee B, Boroumand N et al. Increased detection of rotavirus using a real-time reverse transcription-polymerase chain reaction (RT-PCR) assay in stool specimens from children with diarrhoea. J Med Virol 2004; 72: 496–501.
Fischer TK, Gentsch JR . Rotavirus typing methods and algorithms. Rev Med Virol 2004; 14: 71–82.
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Liakopoulou, E., Mutton, K., Carrington, D. et al. Rotavirus as a significant cause of prolonged diarrhoeal illness and morbidity following allogeneic bone marrow transplantation. Bone Marrow Transplant 36, 691–694 (2005). https://doi.org/10.1038/sj.bmt.1705127
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DOI: https://doi.org/10.1038/sj.bmt.1705127
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