Fecal leukocyte frequency in children with acute viral gastroenteritis: a single-center experience

Rev Assoc Med Bras (1992). 2024 May 3;70(4):e20230972. doi: 10.1590/1806-9282.20230972. eCollection 2024.


Objective: Our objective was to determine the frequency of rotavirus, adenovirus, and rota-adenovirus co-infections and investigate the fecal leukocyte rate associated with these infections in patients with gastroenteritis.

Methods: This is a retrospective study. We identified patients who were admitted to the pediatric emergency department with acute gastroenteritis and had their stool samples tested for rotavirus and/or adenovirus antigens. Among them, we determined the individuals who underwent stool microscopy tests on the same day and recorded their results.

Results: A total of 1,577 patients who underwent testing for rotavirus and/or adenovirus antigens in their stool samples were identified. Among these patients, 583 individuals had concurrent fecal microscopy results. The prevalence of solely rotavirus antigen positivity was 16.4%, solely adenovirus antigen positivity was 2.9%, and rota-adenovirus co-infections were detected in 1.8% of the children. The fecal leukocyte rates in children infected with rotavirus, adenovirus, and rota-adenovirus co-infections were 4.8, 13.3, and 88.9%, respectively.

Conclusion: The presence of fecal leukocytes was detected at a high rate in cases of viral gastroenteritis, especially in rota-adenovirus co-infections. Therefore, clinicians should not consider only bacterial pathogens in the presence of fecal leukocytes.

MeSH terms

  • Acute Disease
  • Adenoviridae / isolation & purification
  • Adenoviridae Infections / epidemiology
  • Adenovirus Infections, Human / epidemiology
  • Child
  • Child, Preschool
  • Coinfection* / epidemiology
  • Feces* / virology
  • Female
  • Gastroenteritis* / epidemiology
  • Gastroenteritis* / virology
  • Humans
  • Infant
  • Leukocyte Count
  • Leukocytes
  • Male
  • Retrospective Studies
  • Rotavirus / immunology
  • Rotavirus / isolation & purification
  • Rotavirus Infections* / epidemiology