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Severity of human parechovirus 3 requires consideration in neonates with meningitis
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SAN DIEGO — A review of human parechovirus cases indicated the need for consideration of human parechovirus 3 when diagnosing neonates with sepsis-like illness or meningitis, according to data presented at IDWeek 2015.
“[Human parechovirus 3 (HPeV3)] is an important virus that can cause severe neurologic illness in very young infants,” study presenter Claire Midgley, PhD, MSc, of the division of viral diseases epidemiology branch at CDC, told Infectious Diseases in Children.
Cerebrospinal fluid samples were collected from children aged younger than 90 days admitted to a pediatric center in Kansas City, Missouri, with sepsis-like illness or meningitis. Symptoms included fever, tachycardia and poor feeding. Midgley and colleagues at the CDC analyzed specimens that tested positive for human parechoviruses via molecular sequencing to determine virus types.
The CDC determined that 32 of the 40 cases of human parechovirus were HPeV3. The other cases either failed sequencing or were unsuccessfully typed. The median age of patients infected with HPeV3 was 24.5 days, and 53% were boys.
Six of the HPeV3-infected patients required neonatal ICU stays for a median of 6.5 days. All were treated with acyclovir, and none tested positive for herpes simplex virus. Neurological manifestations, including eye deviation, limb stiffening and seizures, were observed in five of the patients. Two patients had abnormal white matter changes noted on MRI brain scans.
“More widespread testing for human parechoviruses is recommended to better understand clinical scope and virus circulation,” Midgley and colleagues wrote. – by David Costill
Reference:
Midgley C, et al. Oral Abstract 83. Presented at: IDWeek; Oct. 7-11, 2015; San Diego.
Disclosure: The researchers report no relevant financial disclosures.