Norovirus encephalopathy in a previously healthy child.
Norovirus causes acute gastroenteritis in all age groups. Afebrile convulsion is an occasional neurologic complication in norovirus infection, but encephalitis is rare. We report the case of a previously healthy 15-month-old girl with norovirus encephalopathy who had a poor neurologic outcome. Norovirus (genogroup II) was detected in plasma and stool by real-time reverse transcription polymerase chain reaction, but the cerebrospinal fluid showed negative result for genome. Elevated concentrations of cerebrospinal fluid interleukin-6, interleukin-10, interferon-γ, and tumor necrosis factor-α were observed on the third day of illness. The encephalopathy in our patient may be related to hypercytokinemia rather than to direct viral invasion.
Obinata
Kaoru
K
Department of Pediatrics, Koshigaya Municipal Hospital, Saitama, Japan. obinata@juntendourayasu.jp
Okumura
Akihisa
A
Nakazawa
Tomoyuki
T
Kamata
Ayako
A
Niizuma
Takahiro
T
Kinoshita
Keiji
K
Shimizu
Toshiaki
T
D001921:Brain / Q000473:pathology; D017250:Caliciviridae Infections / Q000097:blood / Q000473:pathology / Q000821:virology*; D016207:Cytokines / Q000097:blood; D002658:Developmental Disabilities / Q000821:virology; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D018792:Encephalitis, Viral / Q000097:blood / Q000473:pathology / Q000821:virology*; D005260:Female; D005334:Fever / Q000821:virology; D005759:Gastroenteritis / Q000175:diagnosis; D006801:Humans; D007223:Infant; D029322:Norovirus / Q000235:genetics / Q000302:isolation & purification*; D011379:Prognosis; D012640:Seizures / Q000821:virology
D016207:Cytokines