Acute leucoencephalopathy in neonate due to rotavirus infection

Case contributed by Dr Vinay V Belaval

Presentation

Full-term delivery. The child was normal up to 5 days. She then developed loose stools and vomiting followed by seizures.

Patient Data

Age: 17 days
Gender: Female

MRI shows symmetrical restricted diffusion in bilateral cerebral periventricular white matter, centrum semiovale, internal capsules, corpus callosum and in ventral brainstem along bilateral corticospinal tracts. These changes are not evident on T2 or FLAIR imaging. No blooming artefact is seen.

These features in the above clinical context are most suggestive of acute leucoencephalopathy due to rotavirus infection. Stool samples were positive for rotavirus.

Case Discussion

Neonatal seizures can be due to multiple causes.  Rotavirus infection in children is common, resulting in diarrhea. Neurological manifestations are less frequently seen. Neonates with history of rotavirus infection usually present with seizures or encephalopathy on day 5 (fifth day fits) of life and this may be associated with adverse neurodevelopmental outcomes of different degrees of severity. Follow-up imaging is essential. 

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Case information

rID: 73105
Published: 25th Dec 2019
Last edited: 7th May 2020
Inclusion in quiz mode: Included
Institution: Belcity Scan and Diagnostic Centre