Severe Neonatal Parechovirus Infection and Similarity With Enterovirus Infection

Abstract

It is not possible to distinguish neonatal PeV from EV infection on the basis of clinical signs. Neonates with PeV or EV infection present with sepsis-like illness and the most frequent signs are fever, seizures, irritability, rash, and feeding problems.

Infiltrating Macrophages Are Key to the Development of Seizures following Virus Infection

“…Therefore, due to the large number and types of viruses, identifying and deciphering the mechanism by which viral infection induces seizures have been challenging. For example, two members of the family Picornaviridae, Enterovirus (EV) and Parechovirus (PeV), have been shown to induce seizures in infected children; however, the available diagnostic tests for EVs do not detect PeVs (2,3). A recent retrospective study, using pediatric cerebrospinal fluid samples previously screened for EV, demonstrated that the inclusion of a novel PeV-specific PCR assay led to a 31% increase in the detection of viruses causing virally induced CNS symptoms and neonatal sepsis (4).…”

Human picornaviruses associated with neurological diseases and their neutralization by antibodies

“…It can cause systemic infections with possible neurological involvement in infants, which are collectively described as 'sepsis-like illnesses' [98,99,104]. Such illnesses typically present with fever, seizures, irritability, respiratory and gastrointestinal problems, and occasional rash, and are indistinguishable from severe EV infections [34,105]. The fraction of symptomatic HPeV-3-infected infants that develop sepsis-like illness can exceed 80 %; most such patients require hospitalization and up to one-third of them are admitted to the ICU [104][105][106].…”

“…Infection of meningeal cells or cells of the ventricular lining results in aseptic meningitis -a non-bacterial inflammation of tissues lining the brain [33]. Infection of neurons with subsequent inflammation of brain parenchyma results in encephalitis, which can have long-term sequelae or be fatal [34]. Inflammation of the spinal cord grey matter results in myelitis and can lead to limb paralysis [33].…”

“…The CNS symptoms of HPeV-3 infection can include meningitis, meningoencephalitis, encephalitis or cerebral haemorrhage, with occasional white-matter alterations [107,108]. Whereas HPeV-3 meningitis typically has a good prognosis, meningoencephalitis entailing white-matter alterations may have long-term sequelae, such as cerebral palsy, learning disabilities, epilepsy or visual impairment [34]. In addition, HPeV-3 is occasionally associated with haemophagocytic lymphohistiocytosis [109] and sudden death syndrome in infants [106].…”

Human Parechoviruses, New Players in the Pathogenesis of Viral Meningitis

“…C-reactive protein remains low or slightly elevated (Pineiro et al, www.intechopen.com 2010; Verboon-Maciolek et al, 2008b; own observations). In some cases liver enzymes can be elevated, sometimes leading to hepatitis and liver necrosis (Levorson et al, 2009;Selvarangan et al, 2011;Verboon-Maciolek et al, 2008b).…”