Rotavirus Leukoencephalopathy in a Preterm: One-year Follow-up

Background Rotavirus infection may present with extraintestinal manifestations in term newborns, including unexplained seizures and apnea. Very little is known about the extraintestinal presentations of rotavirus infection in preterms. Case We discuss a case of rotavirus leukoencephalopathy in a preterm who was readmitted to the neonatal intensive care unit 3 days after initial discharge, primarily for the management of hyperbilirubinemia. On the day of readmission, the baby had self-limiting diarrhea, but there was no dehydration at any stage. After initial phototherapy, the hyperbilirubinemia settled, but the baby suddenly developed unexplained status epilepticus. Metabolic causes of seizures were ruled out. The neonate was managed with antiepileptic drugs and respiratory support. Diagnosis of rotavirus leukoencephalopathy was suggested by the classic magnetic resonance imaging findings and a positive stool antigen test for rotavirus. The baby was discharged without any neurological deficit. The possibility of adverse effects on long-term neurodevelopment has been explained, and the baby is on regular follow-up. The child is now 1 year old, and the developmental age has been matching with chronological age so far. Conclusion Rotavirus infection should be considered in initially healthy neonates with unexplained seizures around day 4-6 of life, even if they are preterms.