Parechovirus neonatal sepsis and meningitis – a (still) poorly recognised agent

Human parechovirus (HPeV), a Picornaviridae virus, is a microorganism associated with respiratory and gastrointestinal infections, in most cases with a benign clinical course. However, some serotypes have been recently associated with a more serious clinical outcome in young children, namely sepsis-...

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Main Authors: Raquel Garrido, Joana Antunes, Helena Pedroso, Madalena Fialho, Manuel Cunha
Format: Article
Language:English
Published: Hygeia Press di Corridori Marinella 2021-11-01
Series:Journal of Pediatric and Neonatal Individualized Medicine
Subjects:
Online Access:https://jpnim.com/index.php/jpnim/article/view/1002
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author Raquel Garrido
Joana Antunes
Helena Pedroso
Madalena Fialho
Manuel Cunha
author_facet Raquel Garrido
Joana Antunes
Helena Pedroso
Madalena Fialho
Manuel Cunha
author_sort Raquel Garrido
collection DOAJ
description Human parechovirus (HPeV), a Picornaviridae virus, is a microorganism associated with respiratory and gastrointestinal infections, in most cases with a benign clinical course. However, some serotypes have been recently associated with a more serious clinical outcome in young children, namely sepsis-like disease and meningitis. In this report, we describe the case of a previously healthy, 11-day-old infant in our Paediatric Emergency Department who presented with high fever, irritability and poor feeding. No other accompanying symptoms, such as respiratory, gastrointestinal or urinary, were shown by the patient. Family history unveiled an 18-month-old sibling with an upper respiratory tract infection. Physical examination was unremarkable. Laboratory testing revealed a normal total white cell count with lymphopenia and a maximum C-reactive protein value of 21.4 mg/L. Cerebrospinal fluid (CSF) analysis showed pleocytosis with high proteinorrachia and normal glycorrhachia. With the clinical suspicion of sepsis, she was hospitalized for clinical surveillance, and empirical antibiotics were administered. Although the bacteriological exams of blood and CSF were negative, RNA of an HPeV was detected in the CSF. She had a favourable clinical course, the cerebral ultrasound was normal, and the clinical follow-up showed adequate psychomotor development until today (18 months old). Recent publications suggested HPeV as one of the major agents of neonatal sepsis and meningitis. Similarly, several other studies reported significant neurological impairments in infants with HPeV infection. In line with these recent findings, we believe this clinical case further supports the need for more extensive research in viral aetiology and in particular of this, not so uncommon, agent in order to avoid unnecessary and potentially harmful interventions in newborns presenting with a sepsis-like clinical picture.
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spelling doaj.art-b8844f63e7f14446b993b7c5098e62272022-12-21T20:35:11ZengHygeia Press di Corridori MarinellaJournal of Pediatric and Neonatal Individualized Medicine2281-06922021-11-01111e110102e11010210.7363/110102843Parechovirus neonatal sepsis and meningitis – a (still) poorly recognised agentRaquel Garrido0Joana Antunes1Helena Pedroso2Madalena Fialho3Manuel Cunha4Pediatric Service, Children Department, Hospital de Cascais Dr. José de Almeida, Cascais, PortugalPediatric Service, Children Department, Hospital de Cascais Dr. José de Almeida, Cascais, PortugalPediatric Service, Children Department, Hospital de Cascais Dr. José de Almeida, Cascais, PortugalPediatric Service, Children Department, Hospital de Cascais Dr. José de Almeida, Cascais, PortugalPediatric Service, Children Department, Hospital de Cascais Dr. José de Almeida, Cascais, PortugalHuman parechovirus (HPeV), a Picornaviridae virus, is a microorganism associated with respiratory and gastrointestinal infections, in most cases with a benign clinical course. However, some serotypes have been recently associated with a more serious clinical outcome in young children, namely sepsis-like disease and meningitis. In this report, we describe the case of a previously healthy, 11-day-old infant in our Paediatric Emergency Department who presented with high fever, irritability and poor feeding. No other accompanying symptoms, such as respiratory, gastrointestinal or urinary, were shown by the patient. Family history unveiled an 18-month-old sibling with an upper respiratory tract infection. Physical examination was unremarkable. Laboratory testing revealed a normal total white cell count with lymphopenia and a maximum C-reactive protein value of 21.4 mg/L. Cerebrospinal fluid (CSF) analysis showed pleocytosis with high proteinorrachia and normal glycorrhachia. With the clinical suspicion of sepsis, she was hospitalized for clinical surveillance, and empirical antibiotics were administered. Although the bacteriological exams of blood and CSF were negative, RNA of an HPeV was detected in the CSF. She had a favourable clinical course, the cerebral ultrasound was normal, and the clinical follow-up showed adequate psychomotor development until today (18 months old). Recent publications suggested HPeV as one of the major agents of neonatal sepsis and meningitis. Similarly, several other studies reported significant neurological impairments in infants with HPeV infection. In line with these recent findings, we believe this clinical case further supports the need for more extensive research in viral aetiology and in particular of this, not so uncommon, agent in order to avoid unnecessary and potentially harmful interventions in newborns presenting with a sepsis-like clinical picture.https://jpnim.com/index.php/jpnim/article/view/1002fever without a sourceneonatal meningitisparechovirusnewborninfantpicornaviridae
spellingShingle Raquel Garrido
Joana Antunes
Helena Pedroso
Madalena Fialho
Manuel Cunha
Parechovirus neonatal sepsis and meningitis – a (still) poorly recognised agent
Journal of Pediatric and Neonatal Individualized Medicine
fever without a source
neonatal meningitis
parechovirus
newborn
infant
picornaviridae
title Parechovirus neonatal sepsis and meningitis – a (still) poorly recognised agent
title_full Parechovirus neonatal sepsis and meningitis – a (still) poorly recognised agent
title_fullStr Parechovirus neonatal sepsis and meningitis – a (still) poorly recognised agent
title_full_unstemmed Parechovirus neonatal sepsis and meningitis – a (still) poorly recognised agent
title_short Parechovirus neonatal sepsis and meningitis – a (still) poorly recognised agent
title_sort parechovirus neonatal sepsis and meningitis a still poorly recognised agent
topic fever without a source
neonatal meningitis
parechovirus
newborn
infant
picornaviridae
url https://jpnim.com/index.php/jpnim/article/view/1002
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AT joanaantunes parechovirusneonatalsepsisandmeningitisastillpoorlyrecognisedagent
AT helenapedroso parechovirusneonatalsepsisandmeningitisastillpoorlyrecognisedagent
AT madalenafialho parechovirusneonatalsepsisandmeningitisastillpoorlyrecognisedagent
AT manuelcunha parechovirusneonatalsepsisandmeningitisastillpoorlyrecognisedagent