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http://dx.doi.org/10.14776/piv.2020.27.e12

Human Parechovirus: an Emerging Cause of Sepsis-Like Syndrome in Infants Aged under 3 Months  

Roh, Da Eun (Department of Pediatrics, School of Medicine, Kyungpook National University, Kyungpook National University Children's Hospital)
Kwon, Jung Eun (Department of Pediatrics, School of Medicine, Kyungpook National University, Kyungpook National University Children's Hospital)
Kim, Yeo Hyang (Department of Pediatrics, School of Medicine, Kyungpook National University, Kyungpook National University Children's Hospital)
Publication Information
Pediatric Infection and Vaccine / v.27, no.2, 2020 , pp. 102-110 More about this Journal
Abstract
Purpose: This study aimed to investigate the clinical characteristics of human parechovirus (HPeV) infection in sepsis-like syndrome in infants aged under 3 months. Methods: Medical records of infants aged under 3 months with sepsis-like symptoms who were admitted between July 1, 2018 and August 31, 2018 were reviewed. A multiplex reverse transcription-polymerase chain reaction panel test was performed on the cerebrospinal fluid (CSF). Thirty-nine enrolled infants were categorized into three groups: 11 in group 1 (HPeV detected in the CSF), 13 in group 2 (enterovirus detected in the CSF), and 15 in group 3 (no virus detected in the CSF). Results: Compared with groups 2 and 3, a higher proportion of group 1 had tachycardia, tachypnea, apnea, and hypotension (P<0.05). A significantly lower white blood cell (WBC) count was noted in group 1 than in groups 2 and 3 (5,622±2,355/μL, 9,397±2,282/μL, and 12,312±7,452/μL, respectively; P=0.005). The CSF WBC count was lower in group 1 than in groups 2 and 3 (0.9±1.7/μL, 85.1±163.6/μL, and 3.7±6.9/μL, respectively; P=0.068). The proportion of patients requiring inotrope support (36.6% vs. 0% and 6.6%), mechanical ventilation (18.1% vs. 0% and 0%), and high flow nasal cannula (45.4% vs. 15.3% and 6.6%) was higher in group 1 than in groups 2 and 3. All patients recovered completely without complications. Conclusions: HPeV infection shows a severe clinical course and can cause a severe sepsis-like syndrome in infants aged under 3 months. Early diagnosis and proper treatment of HPeV infection are required.
Keywords
Fever; Parechovirus; Infant; Sepsis; Systemic inflammatory response syndrome;
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