Objective: To probe into the clinical experience of diagnosis for one child with asymptomatic methylmalonic acidemia (MMA) with initial diagnosis of rotavirus enteritis. Methods: The clinical data of one child diagnosed with asymptomatic MMA with initial diagnosis of rotavirus enteritis were retrospectively analyzed

and the relevant literature were reviewed. Results: The child developed metabolic acidosis

ketonuria

hyperventilation

high blood ammonia

and multiple organ failure after rotavirus infection. After improvement of blood tandem mass spectrometry

urinary gas chromatography-mass spectrometry (GCMS) and gene detection

the diagnosis of methylmalonacidemia (MUT type) was confirmed. The child recovered after feeding with special milk powder

supplementing with levocarnitine and vitamin B12

ventilator assisted ventilation

blood purification and Extracorporeal Membrane Oxygenation (ECMO) treatment. Conclusion: For critically ill children

even if there is no suspicious family history and clinical symptoms of MMA

it cannot be easily ruled out. Once suspicious signs

it is necessary to improve the relevant examination and experimental treatment as soon as possible

so as to improve the prognosis.