Kim JJ, Lee JK. Neonatal erythema multiforme associated with a rotavirus infection: A case report. World J Clin Cases 2023; 11(24): 5749-5754 [PMID: 37727716 DOI: 10.12998/wjcc.v11.i24.5749]
Corresponding Author of This Article
Joon Kee Lee, MD, PhD, Assistant Professor, Department of Pediatrics, Chungbuk National University Hospital, 776 1-Sunhwan-ro, Seowon-gu, Cheongju 28644, South Korea. leejoonkee@chungbuk.ac.kr
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 26, 2023; 11(24): 5749-5754 Published online Aug 26, 2023. doi: 10.12998/wjcc.v11.i24.5749
Neonatal erythema multiforme associated with a rotavirus infection: A case report
Jung Jae Kim, Joon Kee Lee
Jung Jae Kim, Joon Kee Lee, Department of Pediatrics, Chungbuk National University Hospital, Cheongju 28644, South Korea
Joon Kee Lee, Department of Pediatrics, Chungbuk National University, Cheongju 28644, South Korea
Author contributions: Kim JJ and Lee JK were the patient’s attending physicians; Kim JJ reviewed the literature and contributed to manuscript drafting; Kim JJ and Lee JK were responsible for the revision of the manuscript; all authors issued final approval for the version to be submitted.
Informed consent statement: Written informed consent was obtained from the patient’s parents for publication of any accompanying images in the case report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Joon Kee Lee, MD, PhD, Assistant Professor, Department of Pediatrics, Chungbuk National University Hospital, 776 1-Sunhwan-ro, Seowon-gu, Cheongju 28644, South Korea. leejoonkee@chungbuk.ac.kr
Received: April 17, 2023 Peer-review started: April 17, 2023 First decision: July 17, 2023 Revised: July 21, 2023 Accepted: August 2, 2023 Article in press: August 2, 2023 Published online: August 26, 2023 Processing time: 129 Days and 20.4 Hours
Abstract
BACKGROUND
Erythema multiforme (EM) is an extremely rare condition in neonates, and studies suggest its association with certain infections and neonatal vaccinations; however, few specific etiological agents have been identified. Rotavirus, a common pathogenic gastrointestinal virus in the neonatal period that is preventable via vaccination, has not been identified as a possible etiology. We report the case of a neonate who was referred for skin lesions presenting as EM, where a meticulous workup identified rotavirus as the sole causative agent.
CASE SUMMARY
A 14-day-old male infant was admitted to our hospital with a 1-day history of skin lesions. No medical history or medication intake was recorded. Except for the complaint of skin lesions, the caregivers denied any abnormal symptoms. Multiple tests, including routine laboratory evaluations, were performed to identify the cause of skin lesions. Serological tests for Immunoglobulin M for Toxoplasma, Rubella, Cytomegalovirus, Herpes Simplex Virus, and Epstein-Barr virus viral-capsid antigen were all negative. Multiple polymerase chain reaction (PCR) tests for respiratory viruses and bacterial pathogens were negative (including the severe acute respiratory syndrome coronavirus 2). Multiple PCR tests for gastrointestinal viruses and bacterial pathogens demonstrated evidence of rotavirus infection. No growth was reported in the blood and urine cultures. The patient received intravenous fluids for hydration; meanwhile, no other medications were prescribed. The lesions improved rapidly without specific treatment, and full recovery was achieved within a week.
CONCLUSION
The possibility of rotavirus, a major cause of pediatric gastrointestinal infections, being a trigger for neonatal EM should be considered.
Core Tip: Various etiologies, including infections, medications, malignancy, and immunization, are responsible for erythema multiforme (EM). EM is extremely rare in the neonatal period. Some potential causes have been reported in the literature, including hepatitis B vaccination and certain infections. As demonstrated in the current case, rotavirus, which is a common pathogenic gastrointestinal virus in the neonatal period that is preventable via vaccination, could be a cause of EM. Physicians should make their best effort in scrutinizing the etiology of the illness.
