Clinical presentation and management of enterovirus and parechovirus infection in children: A single‐centre study in regional Australia

Abstract

ObjectiveThis study aims to analyse the clinical presentation caused by enterovirus (EV) and/or human parechovirus (HPeV) infection in children, as well as the management of such cases admitted to a regional hospital in Australia.MethodsRetrospective study reviewing medical records.SettingSingle hospital in regional Australia.ParticipantsAll children under 18 years admitted over the 5‐year period beginning from 1 January 2017 with confirmed EV and/or HPeV infection. Cases with clinically insignificant EV/HPeV isolation were excluded.Main Outcome MeasuresData collected included demographic data, signs and symptoms present, specimens of EV/HPeV isolation, co‐occurring pathogens, peak C‐reactive protein (CRP), antibiotic therapy, discharge diagnosis and follow‐up after discharge.ResultsOverall, 27 patients fulfilled the inclusion criteria; 81.5% of the patients were ≤3 months of age with a median of 2 months (interquartile range 1–3); 74.1% were males. The most common clinical features were a fever ≥38°C and irritability/lethargy/high‐pitched cry. 29.6% of the patients had co‐occurring pathogens detected, and a CRP ≤10 mg/L was observed in 77.8% of cases. All but two children were treated with antibiotics while awaiting polymerase chain reaction results. The most common discharge diagnosis was meningitis. In all, 74.1% of the children attended follow‐up appointments.ConclusionsEV and HPeV should be considered as a possible aetiology of fever and irritability/lethargy/high‐pitched cry in children under 3 months.