• Jong-Hwa Kim, Dae Yong Yi, Inseok Lim, Alan C Ward, and Wonyong Kim.
• Department of Microbiology.
• Medicine (Baltimore). 2020 Oct 2; 99 (40): e22641e22641.

RationaleRotavirus is routinely diagnosed by the detection of antigens or the viral genome. However, these tests have limitations, in that they do not detect all rotavirus strains.Patient ConcernsWe present a case of a 27-month-old girl who was hospitalized for 4 days with severe gastroenteritis, including high fever, vomiting, diarrhea, mild dehydration, and periumbilical pain. Notably, the patient previously received the Rotarix vaccine.DiagnosesThe laboratory tests were negative for rotavirus, astrovirus, adenovirus, and norovirus as well as common diarrhea-causing bacteria. Human-bovine recombinant rotavirus was detected by MinION sequencing.InterventionsTo investigate the cause agents from the unexplained severe gastroenteritis infant, the stool sample was prepared by random amplification for Nanopore MinION sequencing.OutcomesTreatment through the administration of ORS solution and galtase powder with probiotics was successful after the diagnosis of unusual rotavirus infection.LessonsThis case report is the first detection of an unusual human-bovine recombinant rotavirus in an idiopathic gastroenteritis using Nanopore MinION sequencing.

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