A 10-month-old with rotavirus gastroenteritis, seizures, anasarca and systemic inflammatory response syndrome and complete recovery

This report describes a 10-month-old infant who presented with generalised tonic clonic seizures following 2 days of vomiting, diarrhoea and a low-grade fever. The patient was moderately dehydrated and the blood investigations were remarkable for hyponatraemia (126 mEq/l), leukocytosis (19.4 × 103/l...

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Bibliographic Details
Published in:BMJ case reports 2011-06, Vol.2011 (jun21 1), p.bcr0420114126-bcr0420114126
Main Authors: Bharwani, Sulaiman S, Shaukat, Qudsia, Basak, Ratna
Format: Article
Language:English
Subjects:
12 Months
Antigens
Biopsy
Blood tests
Cerebrospinal fluid
Edema
Edema - etiology
Edema - therapy
Emergency medical care
Female
Gastroenteritis
Gastroenteritis - complications
Gastroenteritis - therapy
Gastroenteritis - virology
Humans
Hyponatremia
Indian Subcontinent
Infant
Infections
Intensive care
Middle East
Proteins
Remission Induction
Rotavirus
Rotavirus Infections - complications
Rotavirus Infections - therapy
Seizures - etiology
Seizures - therapy
Systemic Inflammatory Response Syndrome - etiology
Systemic Inflammatory Response Syndrome - therapy
Unusual Presentation of More Common Disease/Injury
Urine
Viruses
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Summary:This report describes a 10-month-old infant who presented with generalised tonic clonic seizures following 2 days of vomiting, diarrhoea and a low-grade fever. The patient was moderately dehydrated and the blood investigations were remarkable for hyponatraemia (126 mEq/l), leukocytosis (19.4 × 103/l (46% lymphocytes)), thrombocytosis (637 × 103/l), hypoalbuminaemia (albumin 1.9 g/dl) and elevated C reactive protein (96 mg/l). Stool was positive for white and red blood cells but the cultures for bacteria were negative. Rotavirus antigen in stool was positive. There was microscopic haematuria without proteinuria and the nasogastric aspirate was coffee ground. Generalised oedema with pleural and peritoneal effusions ensued requiring drainage, correction of fluid and electrolytes imbalance and albumin infusions. Over the next 72 h, the patient descended into shock and disseminated intravascular coagulopathy which required packed red blood cells and fresh frozen plasma transfusions. By day 12 the patient was clinically and biochemically normal.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr.04.2011.4126