[Infectious gastroenteritis in the immunocompetent child. Significance of Cryptosporidium spp. and Aeromonas ssp].

Over a one-year period we have examined 390 stool specimens from 210 children hospitalized for infectious gastroenteritis or in whom infectious gastroenteritis occurred during hospitalization. The most prevalent pathogens were rotaviruses (22.4%), followed by enteric salmonella (8.1%), Campylobacter jejuni/coli (2.4%), Cryptosporidium spp. (2.4%) and Aeromonas spp. (1.9%). Both Cryptosporidium spp. and Aeromonas spp. are important pathogens of infectious gastroenteritis in immunocompetent children in Switzerland. For both pathogens the most frequently observed clinical sign was self-limited, watery diarrhea with vomiting and fever often requiring parenteral rehydration. The laboratory findings in our patients revealed a left shift with a rise in total leukocyte count in Aeromonas infections only. Electrolytic disorders were frequently found in infections associated with either pathogen, while marked compensated metabolic acidosis was found with cryptosporidiosis only. This points toward a secretory component as part of the still unclear pathogenetic mechanism. Possible modes of infection in cryptosporidiosis are transmission by infected livestock (calves) and person-to-person communication, and in Aeromonas infections transmission by contaminated food or water. We recommend screening for both pathogens in infectious gastroenteritis of immunocompetent children.