Development of rhabdomyolysis in a child after norovirus gastroenteritis.
In children, the most significant cause of rhabdomyolysis or muscle breakdown is viral infection. However, there are no reports that norovirus, a gastroenteric virus that commonly infects children, specifically causes rhabdomyolysis. Here, we report the first pediatric case of norovirus-associated rhabdomyolysis.



The patient, a 2-year-old boy with fever, diarrhea, and vomiting, was referred to our hospital with dysstasia and transaminitis. He was diagnosed with rhabdomyolysis. Additionally, norovirus genogroup GII was detected from stool samples by real-time quantitative reverse transcription Polymerase Chain Reaction, and thereafter, the norovirus GII.4 variant was identified.



However, the association between rhabdomyolysis and the isolated norovirus variant was not clarified. After treatment the patient recovered without renal failure or disseminated intravascular coagulation. Rhabdomyolysis is a disease for which there is a need for early detection and treatment. If abnormal posture or muscle weakness is observed during the course of gastroenteritis, blood and urinary tests should be performed to rule out rhabdomyolysis.
Department of Pediatrics, Saiseikai Shiga Hospital, Social Welfare Organization, Saiseikai Imperial Gift Foundation Inc, Ritto, Shiga, Japan.
Tomohiro
T
Nishio
Shiga Prefectural Institute of Public Health, Otsu, Shiga, Japan.
Ryoko
R
Yonetani
Department of Pediatrics, Saiseikai Shiga Hospital, Social Welfare Organization, Saiseikai Imperial Gift Foundation Inc, Ritto, Shiga, Japan.
Eisuke
E
Ito
Department of Pediatrics, Saiseikai Shiga Hospital, Social Welfare Organization, Saiseikai Imperial Gift Foundation Inc, Ritto, Shiga, Japan.
Makiko
M
Yoneta
Department of Pediatrics, Shiga University of Medical Science, Otsu, Shiga, Japan.
Yoshihiro
Y
Maruo
Shiga Prefectural Institute of Public Health, Otsu, Shiga, Japan.
Tokiko
T
Yoshida
Department of Pediatrics, Saiseikai Shiga Hospital, Social Welfare Organization, Saiseikai Imperial Gift Foundation Inc, Ritto, Shiga, Japan. tosugimo@koto.kpu-m.ac.jp.|Shiga Saiseikai Nursing School, Social Welfare Organization, Saiseikai Imperial Gift, Foundation Inc, Ritto, Shiga, 520-3046, Japan. tosugimo@koto.kpu-m.ac.jp.
Tohru
T
Sugimoto
D017250:Caliciviridae Infections / Q000150:complications / Q000175:diagnosis*; D002675:Child, Preschool; D005759:Gastroenteritis / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D006801:Humans; D008297:Male; D029322:Norovirus / Q000302:isolation & purification*; D012206:Rhabdomyolysis / Q000175:diagnosis / Q000209:etiology*
Dysstasia; Epidemiology; Gastroenteritis; Norovirus; Rhabdomyolysis