Hemopericardium Following Norovirus Gastroenteritis in a Child: An Uncommon Presentation

Norovirus is a leading cause of acute gastroenteritis in children and is typically a self-limiting illness. Cardiac complications are exceptionally rare. To our knowledge, this is the first reported case of hemopericardium associated with norovirus infection in a child. We describe a 20-month-old previously healthy boy who presented with respiratory distress and fatigue two weeks after an episode of acute norovirus gastroenteritis. Investigations revealed severe anemia, elevated D-dimer, and a large hemorrhagic pericardial effusion with echocardiographic evidence of tamponade. Extensive workup excluded trauma, coagulopathy, autoimmune disease, and other infectious causes. The patient underwent urgent pericardiocentesis, draining 200 mL of hemorrhagic fluid. He improved rapidly and remained asymptomatic, with serial echocardiograms showing complete resolution of the effusion up to six weeks post-discharge. Hemopericardium is a rare but life-threatening complication of pediatric norovirus infection. Clinicians should consider cardiac involvement in children with unexplained cardiopulmonary findings following viral gastroenteritis. Early echocardiography and prompt intervention are essential for favorable outcomes.