Abstract
Human parechoviruses (HPeVs) cause a spectrum of disease ranging from self-limiting illness to severe disease and, sometimes, death. We describe the clinical characteristics and outcomes of HPeV infection in infants. The study describes the clinical and laboratory characteristics and outcomes of infants with HPeV infection during 2008–2012, from three paediatric hospitals in London each with a paediatric intensive care unit. The infants were retrospectively identified through laboratory and patient discharge databases and diagnosed through HPeV PCR. Fifty infants were identified. Half required admission to PICU. Infants less than 3 months were more likely to require PICU (16/25: p < 0.01). Clinical signs at presentation were often indistinguishable from those of bacterial sepsis and meningitis, but inflammatory markers were nearly always (95 % of cases) within normal ranges. Brain MRI showed white matter changes in 10/12 infants. Three of 19 infants with follow-up data (16 %) had significant neurological sequelae.
Conclusion: HPeV may cause severe disease and long-term neurological sequelae in young infants. HPeV should be considered in infants with clinical features of sepsis/meningitis with normal CSF microscopy. Prospective observational studies are warranted to better define the epidemiology of infection and thus inform future treatment trials.
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Abbreviations
- ALT:
-
alanine transaminase
- BAL:
-
broncho-alveolar lavage
- CI:
-
confidence interval
- CSF:
-
cerebrospinal fluid
- EV:
-
enterovirus
- HPeV:
-
human parechovirus
- INR:
-
international normalised ratio
- IQR:
-
interquartile range
- MRI:
-
magnetic resonance imaging
- NPA:
-
nasopharyngeal aspirate
- PCR:
-
polymerase chain reaction
- PICU:
-
paediatric intensive care unit
- RNA:
-
ribonucleic acid
- UTR:
-
untranslated region
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Acknowledgments
The authors thank Dr Muir and Dr Yen for supporting the study with permission to access the local NHS virology laboratory databases; Peter Nutter for extracting the data from the Imperial College Virology database; Catherine O’Sullivan for helping with proforma completion at St Mary’s Imperial College.
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Communicated by Peter de Winter
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Vergnano, S., Kadambari, S., Whalley, K. et al. Characteristics and outcomes of human parechovirus infection in infants (2008–2012). Eur J Pediatr 174, 919–924 (2015). https://doi.org/10.1007/s00431-014-2483-3
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DOI: https://doi.org/10.1007/s00431-014-2483-3