Adenovirus and astrovirus diarrhea in immunocompromised hospitalized patients

BACKGROUND. Acute or chronic diarrheal illness are common complications in immunosupressed patients such as human immunodeficiency virus (VIH)-infecte d, bone marrow or solid organ trasplanted patients and those with leukaemia s or other immune deficiency disorders. Due to the importance of recognizin g the feasibles etiologies of diarrhea in order to give the proper antimicr obial chemotherapy or to avoid a misdiagnosis of rejection in the case of t ransplantated patients, we have investigated adenovirus and astrovirus anti gen in faeces from different immunosupressed patients. PATIENTS AND METHODS. Stool samples from 258 immunodeficient patients hospi talized at Universitary Hospital Complex of Santiago of Compostela with acu te or persistent diarrhea were collected between 1997-99 and assayed for as trovirus and adenovirus antigen. Viral antigen was detected by EIA. Other c ommon enteric pathogens were also assayed. RESULTS. Adenovirus antigen was positive in 5 cases (2%) and astrovirus ant igen in 12 cases (5%). The most commonly patients infected was those with h aematologic disorders and premature infants. HIV-infected patients were pos itive for astroviurs antigen in 3 cases. The majority of the cases were rel ated with disbacteriosis intestinal or other circumstances, such as Clostri dium difficile infection, both associated with prolonged antimicrobial ther apy. CONCLUSIONS. Astrovirus and adenovirus have to be considered as enteropatho gens specially in immunocompromissed hospitalized patients. An accurate dia gnosis about diarrhea etiology is advisable in order to give a specific ant imicrobial therapy, when it be necessary, or to avoid a misdiagnosis of rej ection, in transplantated patients.