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Parechovirus Encephalitis and Neurodevelopmental Outcomes

Philip N Britton1, Russell C Dale2, Michael D Nissen3

  • 1Sydney Medical School, Sydney, Australia; Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia; Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Sydney, Australia; philip.britton@health.nsw.gov.au.

Pediatrics
|January 22, 2016
PubMed

Insights

Human parechovirus (HPeV) encephalitis in infants often presents with seizures and MRI abnormalities. This condition can lead to significant neurodevelopmental issues, including cerebral palsy, even with initially reassuring outcomes.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Neuroscience

Background:

  • Human parechovirus (HPeV) is an emerging cause of encephalitis in infants.
  • Early identification and understanding of clinical features are crucial for managing HPeV encephalitis.
  • The Australian Childhood Encephalitis (ACE) study provides a platform for investigating encephalitis cases.

Purpose of the Study:

  • To describe the clinical characteristics of HPeV encephalitis in infants.
  • To evaluate the short-term and long-term outcomes of HPeV encephalitis.
  • To assess the utility of diagnostic tools in identifying HPeV encephalitis.

Main Methods:

  • Prospective identification of infants with suspected encephalitis in 5 hospitals.
  • Comprehensive data collection including demographics, clinical presentation, laboratory results, and imaging.
  • Neurodevelopmental assessment at 12 months post-discharge using the Ages and Stages Questionnaire (ASQ).

Main Results:

  • Thirteen cases of suspected HPeV encephalitis were identified; 9 confirmed.
  • Confirmed cases were predominantly young, female infants with seizures and white matter diffusion restriction on MRI.
  • While 3/9 showed sequelae at discharge, 5/8 infants had neurodevelopmental sequelae at 12 months, including cerebral palsy and visual impairment.

Conclusions:

  • HPeV encephalitis in infants presents with specific clinical and imaging findings.
  • Cranial ultrasound has limited sensitivity for detecting HPeV encephalitis.
  • HPeV encephalitis is associated with significant neurodevelopmental sequelae, highlighting the need for specific diagnostic testing to avoid missed diagnoses.
Abstract

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