Acute rotavirus gastroenteritis in children less than 5 years old: Salient clinical and laboratory features.

Background: Rotavirus is one of the most common etiological agents that can cause gastroenteritis in young children in many countries worldwide, including Malaysia. The objective of the study was to determine the clinical and laboratory features of acute rotavirus gastroenteritis in children aged less than 5 years.

Materials and methods: This retrospective study involved paediatric patients warded in a tertiary medical centre in Kuala Lumpur for acute gastroenteritis from 2015 to 2022. Data for these children were obtained from the hospital's electronic medical records and online laboratory management system.

Results: Out of a total of 177 patients, 30.5% (54/177) were diagnosed with rotavirus gastroenteritis (RG) and 69.5% (123/177) with non-rotavirus gastroenteritis (NRG). Children with RG were more likely to have vomiting compared to those with NRG (85.2% vs. 68.3%; p=0.026). Dehydration was also significantly associated with RG (64.8% vs. 43.9%; p=0.014). However, RG was less likely to be associated with fever (57.4% vs. 76.4%; p=0.013) and convulsions (0.0% vs. 8.1%; p=0.033). The blood C-reactive protein (CRP) mean and SD in RG were lower (0.86 ± 0.81 vs. 4.26 ± 2.71 mg/L; p=0.001), while the serum urea mean and SD in RG were higher (4.94 ± 3.05 vs. 3.87 ± 2.22 mmol/L; p=0.009).

Conclusion: Despite shared features, RG can be distinguished from NRG based on the presence or absence of vomiting, dehydration, fever and convulsions, as well as the extent of elevation in the serum urea and blood CRP levels.