Pune: A premature infant, born at 35 weeks and weighing 2.05 kg, was successfully treated at Pune’s Ankura Hospital after being diagnosed with an unusual case of rotavirus-induced encephalitis, despite the absence of typical gastrointestinal symptoms associated with the virus.
The baby, the second twin of an IVF-conceived pregnancy, was brought in by parents Suchita (34) and Nilesh Pathak (37) (names changed) when he began showing signs of lethargy and refused to feed at just eight days old. By the following day, his condition had worsened, prompting immediate admission to the hospital’s Neonatal Intensive Care Unit (NICU).
What made the case particularly challenging for the medical team was the lack of common indicators. The infant had no fever, birth complications, or signs of systemic infection. Blood tests, sepsis screens, and cerebrospinal fluid (CSF) analyses were all inconclusive.
Dr. Anusha Rao, a consultant neonatologist at the hospital, explained that an MRI scan eventually revealed subtle damage to the brain’s white matter—areas especially sensitive in premature infants. While the scan pointed toward encephalitis, the exact cause remained a mystery.
To uncover more, the team performed a polymerase chain reaction (PCR) test on the infant’s stool sample. The result came back positive for rotavirus, a common virus typically associated with diarrhea and vomiting in infants and young children. However, in this rare case, it had led to a neurological complication.
Doctors highlighted that rotavirus is known in rare instances to cause neurological symptoms, including encephalopathy and seizures. In this case, the infant experienced unusual symptoms such as bradycardia (a dangerously slow heart rate, dropping to 80 beats per minute) and short periods of apnea (temporary cessation of breathing), which played a crucial role in guiding the diagnosis.
The baby, who had not yet received the rotavirus vaccine typically administered at six weeks of age, responded well to supportive treatment. By the 12th day of admission, his heart rate and breathing had stabilised, and his feeding and alertness gradually returned. By the 16th day, the infant’s neurological function had completely normalised, with no signs of ongoing complications on an EEG.
On day 17, the baby was discharged in stable condition, feeding well and maintaining normal vital signs. A follow-up care plan has been established to monitor the child’s ongoing neurodevelopment.
Doctors emphasised the importance of early recognition of atypical symptoms and quick diagnostic work in managing rare neonatal conditions, especially in premature infants who are yet to receive routine vaccinations.
