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A child with acute encephalopathy associated with quadruple viral infection

Keiko Nakata1, Mitsuru Kashiwagi2, Midori Masuda2

  • 1Department of Infectious Diseases, Osaka Prefectural Institute of Public Health , Osaka , Japan.

Frontiers in Pediatrics
|April 18, 2015
PubMed

Insights

Quadruple virus infection in an infant, including human herpesvirus-6 (HHV-6) and three picornaviruses, may increase the risk of developing acute encephalopathy (AE). This case highlights simultaneous viral infections as a potential risk factor for pediatric AE.

Area of Science:

  • Virology
  • Pediatric Neurology
  • Infectious Diseases

Background:

  • Pediatric acute encephalopathy (AE) is sometimes linked to viral infections, but risk factors remain unclear.
  • Viral infections do not invariably lead to AE, necessitating investigation into contributing factors.
  • The specific role of co-infections in AE pathogenesis requires further elucidation.

Purpose of the Study:

  • To report a rare case of an infant with acute encephalopathy (AE) co-infected with multiple viruses.
  • To investigate potential transmission routes and the role of simultaneous viral infections in AE.
  • To explore the implications of quadruple viral infections in pediatric neurological disorders.

Main Methods:

  • Case report of an infant diagnosed with AE.
  • Comprehensive molecular testing to identify co-infecting viral pathogens.
  • Analysis of potential transmission pathways (vertical, nursery school).

Main Results:

  • The infant presented with AE and was co-infected with human herpesvirus-6 (HHV-6), coxsackievirus A6 (CVA6), Enterovirus D68 (EV-D68), and human parechovirus (HPeV).
  • EV-D68 was vertically transmitted from the mother; CVA6 and HPeV were likely acquired at nursery school.
  • HHV-6 reactivation was also considered.

Conclusions:

  • Simultaneous active infection with four potentially AE-causing viruses is rare and seldom reported.
  • The study proposes that simultaneous viral infection may act as a significant risk factor for the development of AE.
  • The findings underscore the importance of comprehensive nucleic acid-based testing for picornaviruses in diagnosing AE.
Abstract

Keywords:
acute encephalopathycoxsackievirus A6enterovirus D68human herpesvirus-6human parechovirusrisk factorviral co-infection

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