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Updated: May 6, 2026

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Contrasting MRI patterns in early infant human parechovirus CNS infection: a brief report

Aldo Naselli1, Francesca Tota1, Stefania Ielo2

  • 1Neonatal Intensive Care Unit, S. Chiara Hospital, Largo Medaglie d'oro, Trento, 38122, Italy.

European Journal of Pediatrics
|May 4, 2026
PubMed

Insights

Human parechovirus (HPeV) central nervous system (CNS) infections in infants can present with varied brain MRI findings. Normal cerebrospinal fluid (CSF) does not rule out HPeV CNS infection, emphasizing the need for early MRI and molecular testing.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Human parechovirus (HPeV) CNS infection in infants often shows white-matter abnormalities on MRI with minimal CSF pleocytosis.
  • MRI is crucial for detecting CNS involvement, but imaging findings can be diverse.

Purpose of the Study:

  • To describe contrasting MRI patterns in two infants with HPeV CNS infection.
  • To highlight the diagnostic utility of MRI in HPeV CNS infections, even in mild cases.

Main Methods:

  • Case report of two infants with PCR-confirmed HPeV CNS infection.
  • Analysis of brain MRI findings and clinical outcomes.

Main Results:

  • Infant 1: typical white matter diffusion restriction with minimal CSF pleocytosis.
  • Infant 2: isolated leptomeningeal enhancement without parenchymal lesions.
  • Both infants recovered well with normal neurodevelopmental outcomes.

Conclusions:

  • HPeV CNS infection in infants presents a spectrum of MRI findings.
  • Normal or near-normal CSF parameters do not exclude significant CNS involvement.
  • Early MRI combined with molecular testing improves diagnostic accuracy and follow-up strategies for HPeV CNS infections.
Keywords:
Human parechovirusMRIMeningitisNeonatal encephalitisWhite matter injury

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