Extensive white matter abnormalities associated with neonatal Parechovirus (HPeV) infection

White matter changes in the neonatal period are commonly associated with hypoxic-ischaemic injuries and, less frequently, infections. Enteroviral (EV) meningoencephalitis as a cause of extensive white matter changes in newborns is well documented but Human Parechovirus (HPeV) associated with a similar picture has only been recently recognized. We report a case of HPeV-related neonatal meningoencephalitis associated with extensive white matter abnormalities, giving rise to a wide differential diagnosis including consequences of hypoxic-ischaemic encephalopathy (HIE) and periventricular leucomalacia (PVL). This case highlights the importance of excluding both EV and HPeV infection in neonates presenting with signs and symptoms of encephalitis. Moreover, HPeV infection ought to be considered in infants with white matter changes suggestive of HIE but no convincing history of a perinatal hypoxic-ischaemic insult.