We describe a 13-month-old girl who developed convulsive status during an episode of rotavirus
gastroenteritis. Persistent disturbance of consciousness, recurrent seizures, slowing on EEG, high
signal areas on diffusion-weighted MRI, and normal cerebrospinal fl uid confi rmed the diagnosis
of encephalopathy. In addition, hepatosplenomegaly, cytopenias, and a histopathological fi nding of
hemophagocytosis in bone marrow were all observed in this case, and these three conditions together
meet the diagnosis of hemophagocytic lymphohistiocytosis. The patient improved after commencement
of steroid pulse therapy. This case suggests that the pathogenesis of rotavirus-associated encephalopathy
may share some basic pathophysiologic mechanisms with hemophagocytic lymphohistiocytosis.
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