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Volume 16, Number 5—May 2010

CME ACTIVITY

Tropheryma whipplei in Children with Gastroenteritis

Didier RaoultComments to Author , Florence Fenollar, Jean-Marc Rolain, Philippe Minodier, Emmanuelle Bosdure, Wenjun Li, Jean-Marc Garnier, and Hervé Richet
Author affiliations: Université de la Méditerranée, Marseille, France (D. Raoult, F. Fenollar, J.-M. Rolain, W. Li, H. Richet); Pôle de Maladies Infectieuses, Marseille (D. Raoult, F. Fenollar, J.-M. Rolain, H. Richet); Hôpital Nord, Marseille (P. Minodier. J.-M Garnier); Hôpital de la Timone, Marseille (E. Bosdure)

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Table 1

Clinical and biological characteristics and laboratory test results of children 2–­4 years of age with gastroenteritis who tested positive by PCR for Tropheryma whipplei, compared with controls, Marseille, France*

Characteristic T. whipplei PCR positive, n = 36 T. whipplei PCR negative, n = 67† p value
Male sex 19 (53) 35 (52) 0.9
Median age, mo 29 ± 6 29 ± 5 0.7
Sand box contact 4/4 (100) 0/8 (0) 0.002
Anorexia 14 (39) 41 (62) 0.03
Weight loss, kg 0.9 ± 0.6 0.55 ± 0.35 0.045
Vomiting 20 (55.5) 45 (67) 0.2
Abdominal pain 9 (25) 14 (21) 0.3
Dehydration 11 (30.5) 25 (37) 0.5
Watery diarrhea 25 (69) 46 (69) 0.9
Bloody diarrhea 3 (8) 5 (7.5) 0.9
Duration of diarrhea, d 4.5 ± 4 4.5 ± 4 0.9
No. stools/d 6 ± 3 5.5 ± 3 0.2
Length of rehydration required, h 19 ± 10 35 ± 23 0.003
Fever, °C 38 ± 0.9 38.3 ± 1 0.2
Duration of fever, d 1.4 ± 1 3.6 ± 3.7 0.003
Duration of hospitalization, d 1.6 ± 1.5 3.5 ± 3.8 0.01
Peripheral leukocyte count, × 109/L 10 ± 4 14 ± 7 0.2
Neutrophil count, × 109/L 6 ± 3 7.5 ± 6 0.7
Hemoglobin, g/dL 11.8 ± 1.5 11.9 ± 1.5 0.6
Fibrin, g/L 4 ± 0.8 4.2 ± 1.2 0.6
C-reactive protein, mg/mL 24 ± 23 64 ± 87 0.03
Serum albumin, g/L 37 ± 50.2 34 ± 3 0.2
Serum creatinine, mmol/L 37 ± 11 37 ± 12 0.99
Uremia, mmol/L 3.4 ± 2 3.4 ± 2 0.99
Proteinemia, g/L 69 ± 8 68.5 ± 7 0.7
Serum potassium, mmol/L 3.8 ± 0.5 3.9 ± 0.4 0.3
Partial thromboplastin time, s 31 ± 3 32 ± 5 0.6
Prothrombin time, s 83 ± 20 81 ± 17 0.7

*Values are no. (%), no. positive/no. tested (%), or mean ± SD.
†Among 205 case-patients with gastroenteritis who were negative for T. whipplei, data were available for 67 patients.

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