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Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
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Cytomegalovirus (CMV) disease is caused by human cytomegalovirus, a double-stranded DNA virus of the Herpesviridae family. While primary CMV infection is often asymptomatic in immunocompetent individuals, the virus can cause severe disease in neonates and immunocompromised patients. CMV is the most common cause of congenital viral infection in the United States, and a major pathogen in solid organ and hematopoietic stem cell transplant recipients.CMV is transmitted via bodily fluids, sexual...
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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
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Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
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Pediatric parechovirus infections.

Susanna Esposito1, Janette Rahamat-Langendoen2, Beatrice Ascolese1

  • 1Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology
|April 3, 2014
PubMed
Summary

Human parechoviruses (HPeVs) cause mild illnesses but can lead to severe pediatric diseases. Diagnostic tools and treatments are lacking, necessitating further research into these significant viral infections.

Keywords:
EncephalitisHuman parechovirusesMeningitisNeonatal sepsisPicornaviridaeRespiratory infection

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Area of Science:

  • Virology
  • Pediatric Infectious Diseases

Background:

  • Human parechoviruses (HPeVs) are part of the Picornaviridae family, with 16 types identified.
  • HPeV types 1-8 are commonly linked to mild pediatric gastrointestinal or respiratory illnesses.
  • Severe manifestations include myocarditis, encephalitis, meningitis, and fatal neonatal infections, with HPeV3 posing a significant threat to infants.

Purpose of the Study:

  • To highlight the underestimation of HPeV involvement in severe pediatric diseases.
  • To emphasize the limitations in current diagnostic availability and antiviral therapies for HPeVs.
  • To underscore the need for further research into HPeV characteristics and treatment strategies.

Main Methods:

  • Real-time polymerase chain reaction (PCR) assays are the most sensitive detection method for HPeVs.
  • Detection is performed on various clinical samples including stools, respiratory swabs, blood, and cerebrospinal fluid.
  • Phylogenetic analysis of the VP1 encoding region is used for HPeV typing.

Main Results:

  • HPeVs are significantly underdiagnosed in clinical settings due to the lack of routine diagnostic assays.
  • While HPeV types 1, 2, and 4-8 typically cause mild symptoms, they can occasionally lead to severe conditions.
  • HPeV3 is particularly associated with severe neonatal and infant illnesses, including sepsis and central nervous system involvement.

Conclusions:

  • HPeVs represent a substantial, underestimated cause of severe pediatric infectious diseases.
  • Current diagnostic methods are not widely implemented, and effective antiviral treatments are unavailable.
  • Further research is crucial for understanding HPeV, developing diagnostic tools, and creating targeted therapies.