Rotavirus and central nervous system symptoms: cause or contaminant? Case reports and review.
Rotavirus is a common cause of severe gastroenteritis in children. In 2 patients with rotavirus gastroenteritis who developed encephalopathy, rotavirus RNA was detected in the cerebrospinal fluid (CSF) by reverse transcription-polymerase chain reaction; in 1 patient, rotavirus RNA was detected on 2 occasions 3 weeks apart. There are increasing reports of cases in which patients who have seizures after an episode of rotavirus diarrhea have evidence of rotavirus in their CSF. A search of 2 large hospital discharge databases suggested that seizures are noted as part of the discharge diagnosis in the records of, at most, <4% of patients with rotavirus diarrhea versus 7% of patients with bacterial diarrhea. Although evidence suggesting that rotavirus is a cause of central nervous system sequelae remains inconclusive, the 2 case reports presented in this study further illustrate a possible association. Further study is required to determine whether detection of rotavirus in CSF represents a true pathogen, CSF contamination that occurs at the time of lumbar puncture or in the laboratory, or carriage of rotavirus RNA in trafficking lymphocytes.
Lynch
M
M
Viral Gastroenteritis Section, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. mlynch@cdc.gov
Lee
B
B
Azimi
P
P
Gentsch
J
J
Glaser
C
C
Gilliam
S
S
Chang
H G
HG
Ward
R
R
Glass
R I
RI
D002493:Central Nervous System Diseases / Q000209:etiology*; D002555:Cerebrospinal Fluid / Q000821:virology; D002648:Child; D002675:Child, Preschool; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000150:complications* / Q000821:virology; D006801:Humans; D008297:Male; D012401:Rotavirus / Q000302:isolation & purification / Q000502:physiology*; D012400:Rotavirus Infections / Q000150:complications* / Q000821:virology