Pediatr Infect Vaccine.  2016 Dec;23(3):165-171. 10.14776/piv.2016.23.3.165.

Human Parechovirus as an Important Cause of Central Nervous System Infection in Childhood

• Jung HJ
• Choi EH
• Lee HJ

• KMID: 2362474
• DOI: http://doi.org/10.14776/piv.2016.23.3.165

Abstract

PURPOSE
Human parechovirus (HPeV) is an increasingly recognized pathogenic cause of central nervous system (CNS) infection in neonates. However, HPeV infections have not been studied in older children. This study determined the prevalence and clinical features of HPeV CNS infection in children in Korea.
METHODS
Reverse transcription polymerase chain reaction assays were performed using HPeV-specific, 5"² untranslated, region-targeted primers to detect HPeV in cerebrospinal fluid (CSF) samples from children presenting with fever or neurologic symptoms from January 1, 2013, to July 31, 2014. HPeV genotyping was performed by sequencing the viral protein 3/1 region. Clinical and laboratory data were retrospectively abstracted from medical records and compared with those of enterovirus (EV)-positive patients from the same period.
RESULTS
Of 102 CSF samples, six (5.9%) were positive for HPeV; two of 21 EV-positive samples were co-infected with HPeV. All samples were genotype HPeV3. Two HPeV-positive patients were <3 months of age and four others were over 1 year old. While HPeV-positive infants under 1 year of age presented with sepsis-like illness without definite neurologic abnormalities, HPeV-positive children over 1 year of age presented with fever and neurologic symptoms such as seizures, loss of consciousness, and gait disturbance. The CSF findings of HPeV-positive patients were mostly within the normal range, whereas most (73.7%) EV-positive patients had pleocytosis.
CONCLUSIONS
Although HPeV is typically associated with disease in young infants, the results of this study suggest that HPeV is an emerging pathogen of CNS infection with neurologic symptoms in older childhood.

Keyword

Parechovirus; Central nervous system infections; Korea

MeSH Terms

Central Nervous System Infections*
Central Nervous System*
Cerebrospinal Fluid
Child
Enterovirus
Fever
Gait
Genotype
Humans*
Infant
Infant, Newborn
Korea
Leukocytosis
Medical Records
Neurologic Manifestations
Parechovirus*
Polymerase Chain Reaction
Prevalence
Reference Values
Retrospective Studies
Reverse Transcription
Seizures
Unconsciousness

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