Clinical features of nosocomial rotavirus infection in pediatric liver transplant recipients.

A retrospective survey of nosocomial rotavirus infection in pediatric liver transplant recipients was performed. Immunocompetent children with nosocomial infections served as controls. Co-pathogens were not identified. A total of 12 transplant cases and 12 controls could be evaluated. New onset vomiting occurred in 7/8 cases and 6/11 controls lasting an average of 2.8 days per case and 0.8 days per control (p < .05). New onset fever (>38 degrees C) was noted in 8/12 cases and 9/12 controls. New onset occult blood was noted in 7/11 cases and 1/12 controls (p < .01). A concomitant rise and fall in transaminases was noted in 5/12 transplant recipients. Eleven of the 12 were maintained on constant or increased immunosuppression doses without the development of fulminant disease. The presence of increased days of vomiting and occult blood in stools suggests that rotavirus causes a more invasive process in the intestinal mucosa of transplant recipients compared to immunocompetent children. However, the process remains self-limited despite the use of potent immunosuppressives.