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UNLABELLED: Human parechoviruses (HPeVs) cause a spectrum of disease ranging from self-limiting illness to severe disease and, sometimes, death. We describe the clinical characteristics and outcomes of HPeV infection in infants. The study describes the clinical and laboratory characteristics and outcomes of infants with HPeV infection during 2008-2012, from three paediatric hospitals in London each with a paediatric intensive care unit. The infants were retrospectively identified through laboratory and patient discharge databases and diagnosed through HPeV PCR. Fifty infants were identified. Half required admission to PICU. Infants less than 3 months were more likely to require PICU (16/25: p < 0.01). Clinical signs at presentation were often indistinguishable from those of bacterial sepsis and meningitis, but inflammatory markers were nearly always (95 % of cases) within normal ranges. Brain MRI showed white matter changes in 10/12 infants. Three of 19 infants with follow-up data (16 %) had significant neurological sequelae. CONCLUSION: HPeV may cause severe disease and long-term neurological sequelae in young infants. HPeV should be considered in infants with clinical features of sepsis/meningitis with normal CSF microscopy. Prospective observational studies are warranted to better define the epidemiology of infection and thus inform future treatment trials.

Original publication

DOI

10.1007/s00431-014-2483-3

Type

Journal article

Journal

Eur J Pediatr

Publication Date

07/2015

Volume

174

Pages

919 - 924

Keywords

Cerebral Palsy, Feeding Behavior, Female, Fever, Humans, Infant, Infant, Newborn, Intensive Care Units, Pediatric, International Normalized Ratio, Irritable Mood, Language Development Disorders, Length of Stay, Lethargy, Leukocytosis, Liver Function Tests, Magnetic Resonance Imaging, Male, Muscle Hypotonia, Neutropenia, Parechovirus, Patient Admission, Picornaviridae Infections, Retrospective Studies, Seizures, Thrombocytopenia, United Kingdom, Vision Disorders, White Matter