CASE  1

The patient was a 1-year-old male admitted to the hospital in December because of dehydration. His parents reported that he had a 1-day history of fever, diarrhea, emesis, and decreased urine output. On admission, his vital signs revealed a temperature of 39.5EC, slight tachycardia with a pulse of 126 beats/min, and respiration of 32/min. He was less interested in play than usual. His general physical examination was remarkable for dry mouth, decreased tears when crying and hyperactive bowel sounds. Urinalysis was significant for a high specific gravity and ketones (consistent with the patient's dehydration). Stool, blood, and urine samples were sent for culture. A stool sample was also checked for ova and parasites. There were no fecal leukocytes. The patient was given intravenous normal saline and had nothing by mouth. Over the next 48 h his emesis abated. Once he was rehydrated and was tolerating oral feedings, he was discharged home. All routine cultures gave negative results, but a rapid test for rotavirus in stool was positive.

Questions

  1. What type of isolation should the patient be in while in the hospital?  Answer

  2. Why does rotavirus cause a watery diarrhea instead of a bloody diarrhea?   Answer

  3. Describe the rapid test for rotavirus detection.    Answer

  4. What is the best treatment for rotavirus infection?   Answer

  5. Can patients get this infection again?   Answer

  6. Are other family members likely to acquire this infection?   Answer

  7. Is there an effective vaccine to prevent illness?    Answer