Case illustrated
A 38-year-old male with no significant past medical history presented to his primary care physician with nausea, vomiting, diarrhea and rash. Nine days prior to this visit, his son and daughter were sick with fever. They did not have any gastrointestinal symptoms or rash and fever resolved within a few days. Six days prior, the patient developed nausea, vomiting and diarrhea which he attributed to oysters that he ate one night before but no one else had similar symptoms in his family. Although his nausea and vomiting resolved within 48 h, diarrhea persisted. He reported watery stool, 6–8 times per day in frequency. One day prior to presentation, he developed a prurience rash on chest, abdomen and back and sought medical attention. He denied bloody stool, abdominal pain, any recent travel, or animal exposure. His vaccination status was up to date including childhood immunization. He was not taking any medication. Physician examination revealed erythematous maculopapular rash on his chest, abdomen and back (Fig. 1). Enteric panel was positive for rotavirus and he was diagnosed with rotavirus gastroenteritis and viral exanthem. His rash improved shortly after taking H1- and H2-blockers and his diarrhea resolved with supportive care after 10 days of symptoms. After his recovery, he was informed that there had been a outbreak of rotavirus at his children’s daycare.
Fig. 1.
Erythematous maculopapular rash on chest, abdomen and back.
Rotavirus, an RNA virus belonging to the family of Reoviridae, is one of the most frequent cause of diarrhea among infants and children [1]. However, the incidence has decreased significantly in places with successful immunization [2]. Most older children and adults have serum antibodies to rotavirus [3] and repeat infection among older children and adults is usually asymptomatic or mild to moderate in severity but severe adult cases have been reported [4]. Although it is rare, different dermatologic manifestations have been reported possibly associated with this infection including exanthema, Gianotti–Crosti syndrome, and Acute Infantile Hemorrhagic Edema [5]. While rotavirus can be detected by a numerous techniques including antigenic assays and viral culture, multiplexed reverse transcription polymerase chain reaction (RT-PCR) has become a major diagnostic technique in epidemiologic studies. Acute rotavirus infection is usually self-limited and is treated with supportive measures. Primary care physicians and dermatologists need to be aware that rotavirus can cause cutaneous lesions in immunocompetent adults.
CRediT authorship contribution statement
TK: Writing – original draft. KB: Writing – review & editing.
Funding
None.
Ethical approval
The local ethical committee approval does not apply in this case.
Consent
The patient’s written consent was obtained.
Authors’ contributions
TK wrote a first draft of the manuscript. KB critically revised and revised the manuscript. All authors read and approved the final paper.
Conflict of interest
No disclosure.
Acknowledgements
None.
References
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