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Article in Japanese

A fatal case of acute gastroenteritis with co-detection of norovirus and rotavirus

Yuka HAYASHI1), Kazuhiro SHIRAGA1), Sayaka TAKANASHI2), Ai HOSHINO2), Ryo INUZUKA1), Akira OKA1)

Norovirus is a major cause of acute gastroenteritis. Most cases show improvement in vomiting and diarrhea after several days, but occasional cases are complicated by convulsions or even encephalopathy. In several foreign countries where the rotavirus vaccine was introduced into the national immunization program, norovirus has become the leading cause of acute gastroenteritis in children.
This paper reports a fatal case of acute gastroenteritis with co-detection of norovirus and rotavirus. A 1-year-old boy with Down syndrome presented vomiting and diarrhea that had lasted for 2 days to the emergency room. The patient was unresponsive and had hypovolemic shock. His hemodynamics was stabilized with intensive care, however, he developed disseminated intravascular coagulation and acute encephalopathy, and died on the fifth day of admission.
Norovirus and rotavirus were detected by reverse transcription-polymerase chain reaction from his stool. The genome titer of norovirus was estimated to be high, and that of rotavirus low. Furthermore, the rotavirus vaccine he had received might prevent a severe condition. Hence, norovirus was suspected in playing a major pathogenetic role in this case. As there is no specific anti-virus therapy for norovirus infection, further development of the norovirus vaccine is needed urgently.

1) Department of Pediatrics, The University of Tokyo Hospital
2) Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo

Key words norovirus, rotavirus, co-detection, vaccine, fatal case
Received September 19, 2019
Accepted January 6, 2020

32 (1):45─51,2020