Rotavirus infection linked to gastroenteritis, neurological complications in children

Children with rotavirus infection are at risk of developing gastroenteritis with severe but self-limiting neurological manifestations, reveals a study.

“Considering rotavirus in paediatric patients with neurological symptoms such as encephalopathy and encephalitis is therefore important,” the investigators said. “Early detection of rotavirus infection may predict a favourable course of the disease and may thereby prevent unnecessary treatment and should be further investigated.”

Fifty-nine patients with rotavirus were analysed in this study. Of these, 50 (84.7 percent) were hospitalized and 18 (30.5 percent) required intravenous rehydration.

Neurologic complications developed in 10 patients (16.9 percent), six (60.0 percent) of whom presented with encephalopathy. Two patients (20.0 percent) with neurologic symptoms had abnormalities seen on diagnostic imaging.

In this study, children below 18 years of age with a positive rotavirus test in faeces that were either hospitalized or presented at the outpatient clinic or emergency department of a large paediatric hospital in the Netherlands from 1 January 2016 to 31 January 2022 were included.

The investigators only tested rotavirus in case of a severe or abnormal disease course. They then described the clinical characteristics and outcomes with a particular focus on neurological manifestations.

“Rotavirus is the leading cause of complicated gastroenteritis in children younger than 5 years in countries where rotavirus vaccination is not implemented as a routine vaccination,” the investigators said. “Besides the intestinal symptoms that are associated with ordinary gastroenteritis, rotavirus can cause neurological complications.”