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Rotavirus Gastroenteritis Associated with Encephalopathy, Myositis, Transaminitis and Hypoalbuminemia
Maharshi Trivedi1, Abhishek Jain1, Dheeraj Shah2
1Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, 110095, India.
Insights
This case study highlights a rare instance of rotavirus gastroenteritis in a child presenting with encephalopathy and myositis. Early consideration of rotavirus is crucial for diagnosing these severe, non-gastrointestinal symptoms.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Rotavirus gastroenteritis is common in children, but extra-intestinal manifestations are rare.
- Reported rotavirus complications include encephalopathy, myositis, and elevated liver enzymes.
- Simultaneous occurrence of these severe conditions is exceptionally uncommon.
Observation:
- A 17-month-old girl presented with acute rotavirus gastroenteritis (G3+G9P[8] strain).
- The child exhibited hypernatremia, encephalopathy, myositis, transaminitis, and hypoalbuminemia.
- Initial symptoms indicated severe systemic involvement beyond the gastrointestinal tract.
Findings:
- The patient experienced a complete recovery without neurological sequelae.
- Liver enzymes and albumin levels normalized following treatment.
- The case demonstrates a rare, severe extra-intestinal presentation of rotavirus infection.
Implications:
- Rotavirus should be considered in the differential diagnosis of pediatric encephalopathy or myositis, especially with concurrent diarrhea.
- This case underscores the importance of recognizing atypical rotavirus presentations.
- Prompt diagnosis and management can lead to favorable outcomes even in severe cases.
Abstract:
Rotavirus is a common cause of acute gastroenteritis in children. Manifestations of rotavirus gastroenteritis beyond gastrointestinal tract are rare. Rotavirus has been reported to be associated with encephalopathy, myositis and elevated liver enzymes; but simultaneous presentation of all these conditions in the same child is extremely rare. The authors report a case of 17-mo-old girl who presented with acute rotavirus gastroenteritis with G3 + G9P[8] strain associated with hypernatremia, encephalopathy, myositis, transaminitis and hypoalbuminemia. Child had complete recovery with no neurological sequalae on follow-up, and liver enzymes and albumin returned to normal. The authors suggest that rotavirus infection should be considered in the differential diagnosis of a child with encephalopathy or myositis, particularly if associated with acute diarrhea.
