Extraintestinal manifestations of norovirus infection in children


DOI: https://dx.doi.org/10.18565/epidem.2018.4.67-71

Popova R.V., Ruzhentsova T.A.

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia
Norovirus infection ranks second in its frequency in the etiological structure of viral diarrhea. Its gastroenterological symptoms of this infection, as those in infections of other etiology, are commonly accompanied by other extraintestinal manifestations.
Objective. To study the frequency, nature, severity, and duration of extraintestinal manifestations of norovirus infection in children depending on the therapy performed.
Subjects and methods. The investigation enrolled 80 children admitted to the Department of Childhood Infectious Diseases, Mytishchi Town Clinical Hospital (Moscow Region). The norovirus etiology of acute enteric infection (AEI) was confirmed by polymerase chain reaction. Clinical symptoms and the results of laboratory examination, electrocardiography (ECG), echocardiography (EchoCG), and abdominal and renal ultrasonography were assessed.
Results. Rhinopharyngitis was most common (34%) among the extraintestinal clinical manifestations. ECG and EchoCG revealed abnormalities in 71% of the children, there were changes in the pancreas (53%), liver (46%), and kidneys (38%). Extraintestinal symptoms were abolished in the majority of the patients on days 18-25. However, ECG and EchoCG changes remained in 2 children; the enlarged pancreas was present in 8 (19%); there were its parenchymal changes in 11 (29%) and hepatomegaly in 6 (16%).
Conclusion. In many children, the typical gastrointestinal symptoms of norovirus infection are accompanied by the signs of involvement in the infectious and inflammatory process of the hepatobiliary system, pancreas, upper respiratory tract, kidneys, and heart. Active timely combination therapy can reduce the frequency of development, duration, and severity of the main symptoms of both OEI and extraintestinal manifestations. Colloidal silicon dioxide (polysorb) should be considered to be an effective drug to treat norovirus infection in children.
Keywords: colloidal silicon dioxide (polysorb), noroviruses, enterosorbents, norovirus infection, acute enteric infections, diarrhea, children
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For citations: Popova R.V., Ruzhentsova T.A. Extraintestinal manifestations of norovirus infection in children. Èpidemiologiâ i infekcionnye bolezni. Аktual’nye voprosy 2018; (4):67–71 (In Russ.).


About the Autors

Tatiana A. Ruzhentsova, МD, Leading Researcher, Clinical Department of Infectious Pathology, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; е-mail: ruzhencova@gmail.com; ORCID: http://orcid.org/0000-0002-6945-2019
Raisa V. Popova, Laboratory Research Assistant, Clinical Department of Infectious Pathology, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; e-mail: raiakotova@gmail.com


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