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Acute Disseminated Encephalomyelitis After Human Parechovirus Infection

Patrick E Obermeier1, Katharina Karsch, Christian Hoppe

  • 1From the *Department of Pediatrics, Charité University Medical Center; †Medical Bioinformatics Group, Free University; ‡Institute for Cell and Neurobiology, Charité University Medical Center; §Center for Social Pediatrics (SPZ), Charité University Medical Center; and ¶National Reference Center for Poliomyelitis and Enteroviruses, Robert Koch Institute, Berlin, Germany.

The Pediatric Infectious Disease Journal
|January 8, 2016
PubMed
Abstract

Insights

This study identified a case of acute disseminated encephalomyelitis (ADEM) following parechovirus infection in a child. Parechovirus should be considered in ADEM differential diagnoses.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease often triggered by viral infections.
  • Enteroviruses are known ADEM triggers, but the role of parechoviruses remains unclear.

Purpose of the Study:

  • To investigate the prevalence and clinical presentation of ADEM following parechovirus infection.
  • To assess parechovirus as a potential trigger for ADEM in pediatric patients.

Main Methods:

  • Prospective surveillance of hospitalized children with central nervous system (CNS) infection/inflammation in Berlin (2010-2014).
  • Standardized clinical assessments and real-time polymerase chain reaction (PCR) analysis of stool samples for enteroviruses and parechoviruses.

Main Results:

  • 114 cases of ADEM were identified among 774 children with CNS infection/inflammation.
  • Parechoviruses were detected in 2.5% of CNS cases, including one confirmed case of ADEM.

Conclusions:

  • A case of ADEM following parechovirus infection is reported in a 5-year-old female with hemiparesis.
  • Parechovirus infection should be considered in the differential diagnosis of pediatric ADEM.

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