Rotavirus Encephalitis Resulting in Severe Impairment in a Toddler

Background: Neurological complications of rotavirus infection during childhood appear in ~2 to 5% of the cases. Seizures, encephalitis and cerebellitis among others are described. Typically findings in magnetic resonance imaging (MRI) are lesions in the splenium of the corpus callosum and cerebellum.

Methods/Results: We report the case of a 4 year old boy, who presented at the age of 3 years, 5 month with high febrile gastroenteritis and cerebral seizure at our hospital. His stool was tested positive for rotavirus antigen. Over the course of his stay he developed symptoms of meningoencephalitis and cerebellitis (drowsiness, muscular hypotonia, motoric agitation, attacks of screaming and dyskinesia). Cerebral fluid analysis reveals mild pleocytosis and a pathological albumin liquor/serum quotient. We could not prove rotavirus presence in the central nervous system. A cerebral MRI showed lesions in the cerebellum and splenium of the corpus callosum which best presented in the FLAIR and T2 scan. The electroencephalography showed slow brain activity in the low theta and delta spectrum. Despite intensive rehabilitation the boy developed severe speech, motor, and neuropsychologic impairment.

Conclusion: Although the course of rotavirus infection is mostly benign, the presented case shows that individual development can have severe repercussions for the patient. It puts a new spin to this basically innocuous disease.