Background: A preceding viral syndrome is classically cited as a triggering factor for thrombotic microangiopathy although only anecdotal reports of the causal agent have been documented.
Case report: An 84-year-old woman developed thrombotic microangiopathy secondary to diarrhea. An exhaustive etiological work-up documented the presence of Rotavirus alone in the fecal matter. The clinical course was favorable after 9 plasma exchanges using frozen fresh plasma and was associated with disappearance of the Rotavirus.
Discussion: Enterohemorrhagic Escherichia coli is the most commonly identified infectious agent causing thrombotic microangiopathy. A small number of cases caused by viral agents (particularly retroviruses) have also been documented. To our knowledge, this is the first case attributable to a Rotavirus. In our case, the presence of the Rotavirus in the fecal matter and the favorable clinical course when the virus disappeared would be in favor of its causal role in the pathogenesis of thrombotic micorangiopathy.