Rotavirus-associated mild encephalopathy with a reversible splenial lesion (MERS)—case report and review of the literature
Identifieur interne : 001585 ( Main/Exploration ); précédent : 001584; suivant : 001586Rotavirus-associated mild encephalopathy with a reversible splenial lesion (MERS)—case report and review of the literature
Auteurs : Konstantinos Karampatsas [Royaume-Uni] ; Christina Spyridou [Royaume-Uni] ; Ian R. Morrison [Royaume-Uni] ; Cheuk Y. W. Tong [Royaume-Uni] ; Andrew J. Prendergast [Royaume-Uni]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2015.
Descripteurs français
- KwdFr :
- ARN viral (analyse), Corps calleux (imagerie diagnostique), Diarrhée (étiologie), Encéphale (imagerie diagnostique), Encéphalopathies (diagnostic), Encéphalopathies (virologie), Enfant d'âge préscolaire, Fièvre (étiologie), Fèces (virologie), Gastroentérite (diagnostic), Gastroentérite (virologie), Humains, Imagerie par résonance magnétique, Infections du système nerveux central (diagnostic), Infections du système nerveux central (virologie), Mâle, Radiographie, Rotavirus (génétique), Rotavirus (isolement et purification).
- MESH :
- analyse : ARN viral.
- diagnostic : Encéphalopathies, Gastroentérite, Infections du système nerveux central.
- génétique : Rotavirus.
- imagerie diagnostique : Corps calleux, Encéphale.
- isolement et purification : Rotavirus.
- virologie : Encéphalopathies, Fèces, Gastroentérite, Infections du système nerveux central.
- étiologie : Diarrhée, Fièvre.
- Enfant d'âge préscolaire, Humains, Imagerie par résonance magnétique, Mâle, Radiographie.
English descriptors
- KwdEn :
- Brain (diagnostic imaging), Brain Diseases (diagnosis), Brain Diseases (virology), Central Nervous System Infections (diagnosis), Central Nervous System Infections (virology), Child, Preschool, Corpus Callosum (diagnostic imaging), Diarrhea (etiology), Feces (virology), Fever (etiology), Gastroenteritis (diagnosis), Gastroenteritis (virology), Humans, Magnetic Resonance Imaging, Male, RNA, Viral (analysis), Radiography, Rotavirus (genetics), Rotavirus (isolation & purification).
- MESH :
- chemical , analysis : RNA, Viral.
- diagnosis : Brain Diseases, Central Nervous System Infections, Gastroenteritis.
- diagnostic imaging : Brain, Corpus Callosum.
- etiology : Diarrhea, Fever.
- genetics : Rotavirus.
- isolation & purification : Rotavirus.
- virology : Brain Diseases, Central Nervous System Infections, Feces, Gastroenteritis.
- Child, Preschool, Humans, Magnetic Resonance Imaging, Male, Radiography.
Abstract
Rotavirus is the most common cause of severe gastroenteritis in children under the age of 5 years worldwide. It is well recognised that rotavirus can cause signs and symptoms beyond the gastrointestinal tract, including neurological manifestations such as encephalopathy. Mild encephalopathy with a reversible splenial lesion (MERS) is a clinico-radiological syndrome that has been associated with rotavirus. We report a case of a 4-year-old boy with clinically mild encephalopathy, who had an isolated splenial lesion in the corpus callosum on neuroimaging, and rotavirus RNA detected in faeces. We use this case as an opportunity to review the literature on rotavirus-associated MERS.
A previously healthy 4-year-old boy presented with a 2-day history of vomiting, diarrhoea, and fever, complicated by reduced level of consciousness. Magnetic resonance imaging of the brain showed a marked hyperintensity in the splenium of the corpus callosum on T2 and diffusion-weighted images. Rotavirus genome was detected by polymerase chain reaction in a stool specimen, but not in the cerebrospinal fluid. The genotype was identified as G1P8. His clinical condition improved with gradual resolution of his symptoms. No neurological complications were evident upon discharge and the patient had no recurring symptoms or significant residual defects when followed up 2 months later.
MERS is a novel clinic-radiological syndrome first described in Japan. A transient splenial lesion with reduced diffusion that appears as a high signal intensity in diffusion-weighted MRI is the main diagnostic feature. Rotavirus is one of the most common agents associated with MERS, although to our knowledge only one previous case has been reported from Europe. The majority of patients appear to achieve full recovery following rotavirus-associated MERS, irrespective of treatment. This case, together with other published reports, supports the hypothesis that rotavirus-associated MERS is unlikely to be the result of direct viral invasion of the CNS. It has been suggested that MERS may be caused by intra-myelinic axonal oedema or local inflammatory cell infiltration; however, the pathogenesis remains incompletely understood.
Url:
DOI: 10.1186/s12879-015-1192-5
PubMed: 26499987
PubMed Central: 4619335
Affiliations:
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Le document en format XML
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<term>Central Nervous System Infections (diagnosis)</term>
<term>Central Nervous System Infections (virology)</term>
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<term>Infections du système nerveux central (diagnostic)</term>
<term>Infections du système nerveux central (virologie)</term>
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<term>Radiographie</term>
<term>Rotavirus (génétique)</term>
<term>Rotavirus (isolement et purification)</term>
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<term>Gastroentérite</term>
<term>Infections du système nerveux central</term>
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<term>Corpus Callosum</term>
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<term>Fever</term>
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<keywords scheme="MESH" qualifier="genetics" xml:lang="en"><term>Rotavirus</term>
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<term>Encéphale</term>
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<term>Gastroentérite</term>
<term>Infections du système nerveux central</term>
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<term>Central Nervous System Infections</term>
<term>Feces</term>
<term>Gastroenteritis</term>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Rotavirus is the most common cause of severe gastroenteritis in children under the age of 5 years worldwide. It is well recognised that rotavirus can cause signs and symptoms beyond the gastrointestinal tract, including neurological manifestations such as encephalopathy. Mild encephalopathy with a reversible splenial lesion (MERS) is a clinico-radiological syndrome that has been associated with rotavirus. We report a case of a 4-year-old boy with clinically mild encephalopathy, who had an isolated splenial lesion in the corpus callosum on neuroimaging, and rotavirus RNA detected in faeces. We use this case as an opportunity to review the literature on rotavirus-associated MERS.</p>
</sec>
<sec><title>Case presentation</title>
<p>A previously healthy 4-year-old boy presented with a 2-day history of vomiting, diarrhoea, and fever, complicated by reduced level of consciousness. Magnetic resonance imaging of the brain showed a marked hyperintensity in the splenium of the corpus callosum on T2 and diffusion-weighted images. Rotavirus genome was detected by polymerase chain reaction in a stool specimen, but not in the cerebrospinal fluid. The genotype was identified as G1P8. His clinical condition improved with gradual resolution of his symptoms. No neurological complications were evident upon discharge and the patient had no recurring symptoms or significant residual defects when followed up 2 months later.</p>
</sec>
<sec><title>Conclusion</title>
<p>MERS is a novel clinic-radiological syndrome first described in Japan. A transient splenial lesion with reduced diffusion that appears as a high signal intensity in diffusion-weighted MRI is the main diagnostic feature. Rotavirus is one of the most common agents associated with MERS, although to our knowledge only one previous case has been reported from Europe. The majority of patients appear to achieve full recovery following rotavirus-associated MERS, irrespective of treatment. This case, together with other published reports, supports the hypothesis that rotavirus-associated MERS is unlikely to be the result of direct viral invasion of the CNS. It has been suggested that MERS may be caused by intra-myelinic axonal oedema or local inflammatory cell infiltration; however, the pathogenesis remains incompletely understood.</p>
</sec>
</div>
</front>
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</TEI>
<affiliations><list><country><li>Royaume-Uni</li>
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</record>
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