Pediatric gastroenteritis in primary care and in hospitalized patients.

One-hundred and fifty-seven consecutive children below seven years of age (primary care n = 48, hospitalized patients n = 109) with acute gastroenteritis of assumed infectious origin were studied. Rotavirus was demonstrated by electron microscopy of faeces in 44% of all patients. The occurrence of rotavirus among patients in primary care, 15%, was significantly lower than among hospitalized patients, 57% (p less than 0.01). Adenovirus was isolated in six per cent and enterovirus in two per cent of the patients with no differences between the two groups. Yersinia enterocolitica and Campylobacter jejuni were demonstrated in each three per cent. Salmonella and Shigella spp. or Giardia lamblia were not found in any cases. Thus the cause of gastroenteritis was established in 58% of the patients. This figure was lower among patients in primary care (27%) than among hospitalized patients (72%), a difference mainly due to the high occurrence of rotavirus in the latter group. Clostridium difficile was recovered in 20 cases (12%), eight of which harboured one more enteropathogenic agent. Cultures from the nose and throat revealed Streptococcus pneumoniae, Haemophilus influenzae, Branhamella catarrhalis or group A, C and G streptococci in 58% of the patients with no differences regarding the occurrence of rotavirus in faeces. Neither Clostridium difficile nor respiratory tract pathogens were found to play a role in causation of gastroenteritis in the children investigated.