Rotavirusinfectie bij een neonaat

Niet zo onschuldig als verwacht
Casuïstiek
25-11-2019
Alja Bijlsma, Marieke A.C. Hemels, H.L.M. (Irma) van Straaten, Sylvia B. Debast en Esther J. d’Haens

Rotavirus infections in neonates: not as innocent as expected

Background

Rotavirus is a common cause of gastroenteritis in children. It is much less known that rotavirus infections can lead to encephalitis with convulsions in neonates.

Case description

A premature boy (36 weeks + 5 days) developed neonatal convulsions 17 days post-partum. His sister had symptoms of gastroenteritis. Cerebral MRIs showed extensive white matter abnormalities in diffusion-weighted images and, a few weeks later, cystic white matter abnormalities. There were no gastrointestinal phenomena or pleocytosis in the cerebrospinal fluid. Rotavirus was detected in the stools, using molecular diagnostics (PCR).

Conclusion

Rotavirus infection at a neonatal age can have serious consequences. Due to the absence of gastrointestinal phenomena, pleocytosis and demonstrability of rotavirus in faeces and not in CSF, this clinical picture has long remained undiagnosed. Instructions on hand hygiene during the post-partum period contributes to the prevention of rotavirus infection in neonates. Herd immunity through rotavirus vaccination for all neonates could lead to significant risk reduction.

Conflict of interest and financial support: none declared.