Abstract
Background: Rotavirus can cause severe complications such as encephalopathy/encephalitis and
sudden unexpected death. The incidence of rotavirus-associated encephalopathy/encephalitis
or sudden unexpected death remains unknown. To clarify the clinical features of rotavirus-associated
encephalitis/encephalopathy and sudden unexpected death, we conducted a nationwide
survey in Japan. Method: A two-part questionnaire was designed to determine the number of the cases and the
clinical features of severe cases of rotavirus infection, including encephalitis/encephalopathy
and sudden unexpected death, between 2009 and 2011. Result: Of the 1365 questionnaires sent to hospitals, 963 (70.5%) were returned and eligible
for analysis. We determined 58 cases of rotavirus-associated encephalitis/encephalopathy
and 7 cases of sudden unexpected death. These patients were diagnosed with rotavirus
infection by immunochromatography. Although 36/58 (62.1%) encephalitis/encephalopathy
patients had no sequelae, 15/58 (25.9%) patients had neurological sequelae, and 7/58
(12.1%) patients had fatal outcomes. Pleocytosis was observed in 9/40 (22.5%) patients
and cerebrospinal fluid protein levels were elevated in only 4/40 (10%) patients.
Elevated lactate dehydrogenase (LDH) (>500 IU/L) or acidemia (pH < 7.15) were related to a poor prognosis. Conclusion: We estimate that annual cases of rotavirus-associated encephalitis/encephalopathy
and sudden unexpected death were 44.0 and 4.9 cases in Japan, respectively. Elevated
LDH (>500 IU/L) or acidemia (pH < 7.15) were related to a poor prognosis of the encephalitis/encephalopathy.
Keywords
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Article info
Publication history
Published online: August 23, 2013
Accepted:
July 30,
2013
Received in revised form:
July 29,
2013
Received:
February 7,
2013
Identification
Copyright
© 2013 The Japanese Society of Child Neurology. Published by Elsevier Inc. All rights reserved.
