Volume 4 • Issue 1 • 1000189 Open Access Research Article J AIDS Clin Res ISSN:2155-6113 JAR an open access journal Noorbakhsh et al., J AIDS Clin Res 2013, 4:1 DOI: 10.4172/2155-6113.1000189 Neurological Manifestaions in Acute Onset of Viral Gastroentritis Samileh Noorbakhsh 1 *, Hamid Reza Monavari 2 and Azardokht Tabatabaei 3 1 Professor of Pediatric Infectious Diseases, Research Center of Pediatric Infectious, Diseases, Tehran University of Medical Sciences, Iran 2 Research Center of Pediatric Infectious, Diseases, Tehran University of Medical Sciences, Iran 3 Microbiologist, Research Center of Pediatric Infectious Diseases, Tehran University of Medical Sciences, Iran *Corresponding author: Samileh Noorbakhsh, Research Center of Pediatric Iinfectious Diseases, Tehran University of Medical Sciences, 4 th foor Hazrat Rasul Hospital, Niayesh Street, Satarkhan Avenue, Tehran, 14455 Islamic Republic of Iran, Tel: 098-21-66525328; Fax: 098-21-66516049; E-mail: Samileh_noorbakhsh@yahoo.com, S-noorbaqkhsh@tums.ac.ir Received November 19, 2012; Accepted December 10, 2012; Published December 18, 2012 Citation: Noorbakhsh S, Monavari HR, Tabatabaei A (2013) Neurological Manifestaions in Acute Onset of Viral Gastroentritis. J AIDS Clin Res 4: 189. doi:10.4172/2155-6113.1000189 Copyright: © 2013 Noorbakhsh S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Keywords: Convulsion; Diarrhea; Viral gastroenteritis; Neurologic symptoms; Rota virus; Adeno virus; Human Boca Virus Introduction Acute gastroenteritis (AGE) known by vomiting, diarrhea and dehydration [1]. Acute diarrhea disease is the second cause of death among all infectious diseases in children younger than 5 years of age worldwide [2,3]. AGE is one of the most common cause of morbidity and mortality in infants and children in developing countries with near 11,000 deaths per day in the world [4,5]. Viral AGE is a major cause of morbidity in childhood and leaded to be hospitalized even in developed countries. Different types of viruses such as norovirus, rotavirus, astrovirus, adenovirus, enterovirus, parechovirus causes AGE diseases. Rotavirus is a common cause of severe gastroenteritis in children [1,2]. Tere are increasing reports of cases in which patients who have seizures afer an episode of rotavirus diarrhea have evidence of rotavirus in their CSF [3]. Although evidence suggesting that rotavirus is a cause of central nervous system squeal remains inconclusive [4-6]. Rotavirus- associated encephalopathy described by some authors. Nakagomi et al. study [7] determined the rotavirus antigen in acute phase sera from 5 of 8 children with rotavirus-associated encephalopathy, confrming antigenemia, but not in cerebrospinal fuid, failing to provide added evidence of invasion to the brain [7]. Enteric adenoviruses, i.e. adenovirus 40 (Ad40) and adenovirus 41 (Ad41), have been shown to be a substantial cause of pediatric gastroenteritis in various parts of the world and may be the second major causative agent of gastroenteritis afer rotaviruses [1,2]. Human bocavirus (HBoV) is a recently discovered virus of the family Parvoviridae, genus Bocavirus, as a new agent associated with respiratory tract infections (RTI) and AGEn children [8]. Te range of seroprevalence is from 48% to 85% at the age of 4 years. Te peak of HBoV is in winter months and is ofen found in coincidence with other pathogens. Some studies showed that HBoV is responsible for severe infections of the lower respiratory tract in small children but less data are available on the role of HBoV in gastroenteritis [7]. Te frequency of HBoV difers between countries (Canada 1.5%, Sweden 3.1%, Australia Abstract Back ground: AGE is one of the most common causes of morbidity and mortality in infants and children in developing countries with near 11,000 deaths per day in the world. Objective: To evaluate the prevalence of neurological manifestations in acute onset of viral gastrointestinal. Methods: A cross sectional /descriptive study performed upon 50 children admitted due to acute viral gastrointestinal infections in Department of pediatric Infectious Disease, Rasul Hospital, Tehran, Iran, 2010- 2011. Initially, a questionnaire was completed by an authorized physician for each cases (eg: age, gender, clinical signs, vomiting, diarrhea (type, time of onset, frequency) attending time from onset ,type of neurologic symptoms ,analysis of lab test (stool direct exams, biochemical parameters, stool culture, direct viral test in stool). All cases with bacterial or other known causes (except viral causes) for gastroenteritis, chronic diarrhea excluded from study. The studied cases were evaluated for existence of neurologic signs .Stool samples were searched for viral antigens (Rota & Adeno virus) by Rapid immune chromatographic test. P-values less than 0.05 were considered statistically signifcant. Results: Neurological manifestations observed in 16% of cases included seizure 12% aseptic meningitis 4%, 20% of adenoviral, 13.5% of rota virus and 33.3% of bi-infection had neurologic signs, with no differences (P=0.619). Mean age of cases had not signifcant difference between cases with and without neurologic manifestation. There was no signifcant association between neurological symptoms with age (P=0.755), sex, virus type and attending time (P>0.05). Conclusions: This study indicated that viral agents, especially rota virus can be obtained from near 60% of studied cases. Adenovirus (20%); Human Boca virus (8%) and other (undiagnosed) viral infection were less common causes. Neurological symptoms including seizure or aseptic meningitis might observe in 16% of children especially in cases with co-infection rota and adenoviral infection (33.3%) which is not related to age, sex and attending time. Rotavirus-associated encephalopathy described by some authors. Due to presence a safe and effective rotavirus vaccination, we prefer to routine usage of it as a public health priority in Iran. Further study is required to determine the role of rotavirus and other viral infection in diarrhea associated encephalopathy. J o u r n a l o f A I D S & C l i n i c a l R e s e a r c h ISSN: 2155-6113 Journal of AIDS & Clinical Research