Neonatal erythema multiforme associated with a rotavirus infection: A case report

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.