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Human parechovirus central nervous system infections in southern California children

Susanna Felsenstein1, Shangxin Yang, Natalie Eubanks

  • 1From the *Division of Pediatric Infectious Diseases; †Molecular Microbiology Laboratory Services; and ‡Department of Radiology, Children's Hospital Los Angeles, Los Angeles, CA.

The Pediatric Infectious Disease Journal
|October 10, 2013
PubMed

Insights

Human parechoviruses (hPeV) are a significant cause of meningoencephalitis in infants. Testing for hPeV in cerebrospinal fluid (CSF) is crucial, even with normal CSF parameters, due to frequent neurological symptoms.

Area of Science:

  • Virology
  • Pediatric Neurology
  • Infectious Diseases

Background:

  • Human parechoviruses (hPeV) are increasingly identified as causes of meningoencephalitis in young children.
  • Cerebrospinal fluid (CSF) testing for hPeV via PCR is not standard practice.

Purpose of the Study:

  • To evaluate the prevalence and clinical presentation of hPeV in pediatric CSF samples.
  • To compare hPeV infections with enterovirus (EV) infections in children with central nervous system symptoms.

Main Methods:

  • Real-time reverse transcriptase PCR was used to detect hPeV serotypes 1-6 in 440 pediatric CSF samples.
  • Prevalence and clinical features of hPeV-positive CSF were compared to EV-positive CSF.

Main Results:

  • hPeV was detected in 2.7% of CSF samples, while EV was found in 10.7%.
  • hPeV-positive infants were typically under 3 months old and often had normal CSF parameters.
  • Neurological symptoms were more frequent in children with hPeV-positive CSF compared to those with EV-positive CSF.

Conclusions:

  • hPeV central nervous system infections predominantly affect young infants and are associated with neurological symptoms, even with normal CSF findings.
  • hPeV should be considered in the differential diagnosis for young children presenting with central nervous system symptoms or sepsis-like illness, irrespective of CSF results.
Abstract

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