Rotavirus-Associated Myositis in a 12-Year-Old Child

TL;DR

A 12-year-old vaccinated girl with rotavirus had elevated muscle enzymes, suggesting rare rotavirus-associated myositis, even without muscle symptoms.

Contribution

Reports a rare case of rotavirus-associated myositis in a vaccinated child, emphasizing underrecognition in pediatric patients.

Findings

Elevated CK and aldolase levels indicated skeletal muscle involvement despite no muscle pain or weakness.

CK-MM isoenzyme predominance suggested myositis rather than rhabdomyolysis or myocardial involvement.

The patient recovered with supportive care, but reported mild fatigue after discharge.

Abstract

Rotavirus infection is a common cause of pediatric gastroenteritis, often self-limited but occasionally associated with extraintestinal complications. This report describes a 12-year-old vaccinated girl who presented with acute gastroenteritis and an incidental elevation of serum creatine kinase (CK). Despite the absence of muscle pain or weakness during hospitalization, laboratory findings indicated skeletal muscle involvement, with elevated CK and aldolase levels, and a predominance of CK-MM isoenzyme. Myocardial involvement and rhabdomyolysis were ruled out. The patient recovered with supportive care, and CK levels normalized after discharge, although she reported mild post-discharge fatigue. Rotavirus-associated myositis is rare and likely underrecognized, particularly in young children who may not verbalize muscle symptoms. This case highlights the importance of considering myositis in patients with elevated CK during rotavirus infection, even in the absence of overt muscular symptoms.

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