A rotavirus infection is a viral infection by a rotavirus, an RNA virus which belongs to the Reoviridae family. This disease mainly affects children, resulting in gastroenteritis that may be accompanied by systemic manifestations.
Rotavirus is a double-stranded RNA virus, that is categorized under the family of Reoviridae. It is responsible for the onset of severe gastroenteritis, being the primary culprit behind exhausting diarrhea amongst pediatric patients [1] [2].
Typical symptoms associated with a rotavirus infection encompass all the manifestations of acute gastroenteritis, that persists for 3 to 8 days on average. Multiple episodes of diarrhea are accompanied by vomiting, nausea, widespread abdominal pain, and cramping. Bloody diarrhea is not reported as a rotavirus infection-related manifestation. Patients are most commonly children, who may often be febrile and report a decreased appetite and fatigue.
Gastroenteritis that is caused by a rotavirus is usually attributed to the serogroup A rotavirus pathogen [3]. Symptomatology is profound and children run the risk of developing dehydration as a result of massive diarrhea. Dehydrated patients exhibit diminished urine output, decreased skin turgor, and hypotension. Rotavirus infection in infants leads to the same symptoms, including severe diarrhea, vomiting, and fever; dehydration also leads to sunken fontanelles, a decreased production of tears, lethargy, and irritability.
Adults are not frequently infected by rotavirus. When the infection does occur, manifestations vary between a complete absence of complaints and nausea, vomiting, diarrhea, fever, and fatigue [4]. An equally variable is the clinical presentation in immunodeficient adults [4].
Although gastroenteritis is the predominant manifestation of a rotavirus infection, isolated studies have proposed a potential causal association between rotavirus infection and manifestations encompassing epileptic seizures, inflammation of the cerebellum, pneumonia, and rash [5] [6] [7] [8] [9].
In order to accurately diagnose a rotavirus infection, a complete medical history is required. Patients are typically in their childhood and present with signs and symptoms consistent with profound gastroenteritis, such as many reported episodes of diarrhea, vomiting, fatigue, and nausea; they may also be dehydrated to a severe extent.
A complete blood count (CBC) and a thorough biochemical profile is the first step towards a successful diagnosis. Leucocytosis and leukocyte type, inflammation markers, and electrolytes levels can help to confirm inflammation and its general origin. The detection of rotavirus is rendered possible through the analysis of a stool sample. Various techniques can be employed towards this aim, including a culture, electron microscopy, latex agglutination, reverse transcriptase polymerase chain reaction (RT-PCR), and an enzyme immunoassay; the latter is the most common method used [10]. Studies have revealed high levels of sensitivity and specificity (over 91%) for an enzyme immunoassay and latex agglutination, although a considerable variability in the results has been reported [11].
In general, despite the fact that a rotavirus infection can be identified by laboratory tests, those tend to be time-consuming and do not contribute to the acute therapeutic plan in an emergency department. Viral detection is carried out for public health or research purposes.