3430 Endoscopic assessment of diarrhea in an adult rotavirus positive population.

Abstract

Background: Rotavirus infection in young children often manifests with the typical signs or symptoms of winter vomiting and diarrhea. But there may be no established consensus on adult infection except in mass outbreak or travelers. Besides there have been no reports about endoscopic assessment of rotavirus gastroenteritis.We report our preliminary results with the colonoscopic findings and diagnosis of rotavirus infection in adults. Patients and Methods: Rotavirus was evaluated by ELISA method (Cambridge Biotech Co.) in adult diarrhea patients. Rotavirus infection was diagnosed in 97 patients and colonoscopy with biopsy was carried out in 62 ( 23M; 18F, age range 13- 91 [mean 43]) out of them. Endoscopic findings were analyzed as to the characteristics of mucosal changes. The biopsy specimens were prepared for HE staining, electron microscopy, and immunostaining use. Results: We found macroscopic change of colon mucosa in 41(66%) out of 62 rotavirus positive patients. Endoscopic findings included various changes such as erythema, longitudinal ulcer , aphthoid ulcer, and pseudomembranous lesion. Erythema was most frequently observed, in 31 patients (76%) and others were minor in prevalence. Conclusion:Rotavirus infection has been supposed to damage the small intestine mucosa and cause diarrhea. It was suggested rotavirus possibly invade not only small intestine but also colon.We have gotten a small clue about it from colonoscopic findings.