Key result
Group A rotavirus antigen appears in serum but not CSF in pediatric mild encephalopathy cases.
Case Report (n=2)
No
Reversible splenial changes in patients with rotavirus infection may be caused by indirect effects to the central nervous system rather than direct viral invasion of the cerebrospinal fluid.
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May prompt rotavirus testing in pediatric MERS; leaves open causality and prevalence in larger cohorts.
We report on two children with mild encephalopathy with a reversible splenial lesion associated with group A rotavirus (GARV) infection. We examined stool, serum, and cerebrospinal fluid samples to determine the presence of the GARV VP7 gene and GARV antigen by reverse-transcription PCR and enzyme-linked immunosorbent assay, respectively. GARV antigen was detected in stool samples from both patients. The GARV G genotype was G9 in one child and G3 in the other. GARV antigens were also found in both serum samples. However, the GARV VP7 gene was detected in only one serum sample, which was collected on the first day of symptomatic illness. Neither GARV antigen nor the VP7 gene was detected in cerebrospinal fluid samples. Both patients had excellent outcomes. Our results suggest that the reversible splenial changes in our patients might have been caused by indirect effects to the central nervous system subsequent to viral infection.
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Arakawa et al. (2011) conducted a case report in Mild encephalopathy with a reversible splenial lesion (MERS) associated with group A rotavirus (GARV) infection (n=2). Group A rotavirus (GARV) infection was evaluated on Detection of GARV RNA and antigen in serum and cerebrospinal fluid. In two children with mild encephalopathy with a reversible splenial lesion, group A rotavirus antigen was detected in serum but neither antigen nor RNA was detected in cerebrospinal fluid.
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