Rotavirus and central nervous system symptoms: Cause or contaminant? Case reports and review

Rotavirus is a common cause of severe gastroenteritis in children. In 2 pat ients with rotavirus gastroenteritis who developed encephalopathy, rotaviru s RNA was detected in the cerebrospinal fluid (CSF) by reverse transcriptio n-polymerase chain reaction; in I patient, rotavirus RNA was detected on 2 occasions 3 weeks apart. There are increasing reports of cases in which pat ients who have seizures after an episode of rotavirus diarrhea have evidenc e of rotavirus in their CSF. A search of 2 large hospital discharge databas es suggested that seizures are noted as part of the discharge diagnosis in the records of, at most, <4% of patients with rota,,virus diarrhea versus 7 % of patients with bacterial diarrhea. Although evidence suggesting that ro tavirus is a cause of central nervous system sequelae remains inconclusive, the 2 case reports presented in this study further illustrate a possible a ssociation. Further study is required to determine whether detection of rot avirus in CSF represents a true pathogen, CSF contamination that occurs at the time of lumbar puncture or in the laboratory, or carriage of rotavirus RNA in trafficking lymphocytes.