CLINICAL-FEATURES OF NOSOCOMIAL ROTAVIRUS INFECTION IN PEDIATRIC LIVER-TRANSPLANT RECIPIENTS

A retrospective survey of nosocomial rotavirus infection in pediatric liver transplant recipients was performed. Immunocompetent children wi th nosocomial infections served as controls. Go-pathogens were not ide ntified. A total of 12 transplant cases and 12 controls could be evalu ated. New onset vomiting occurred in 7/8 cases and 6/11 controls lasti ng an average of 2.8 days per case and 0.8 days per control (p<.O5). N ew onset fever (>38 degrees C) was noted in 8/12 cases and 9/12 contro ls. New onset occult blood was noted in 7/11 cases and 1/12 controls ( p<.01). A concomitant rise and fall in transaminases was noted in 5/12 transplant recipients. Eleven of the 12 were maintained on constant o r increased immunosuppression doses without the development of fulmina nt disease. The presence of increased days of vomiting and occult bloo d in stools suggests that rotavirus causes a more invasive process in the intestinal mucosa of transplant recipients compared to immunocompe tent children. However, the process remains self-limited despite the u se of potent immunosuppressives.