Relevance of human parechovirus detection in cerebrospinal fluid samples from young infants with sepsis-like illness

J Clin Lab Anal. 2015 Mar;29(2):112-5. doi: 10.1002/jcla.21737. Epub 2014 Mar 28.

Abstract

Background: The human parechoviruses (HPeVs) were recently recognized as important viral pathogens involved in various illnesses in young children. However, routine detection is not performed in most clinical laboratories. Therefore, in this study, we aim to assess the relevance of HPeV detection in cerebrospinal fluid (CSF) of infants, according to clinical presentation.

Methods: A total of 120 CSF specimens collected during 2012 from infants aged less than 1 year and previously reported negative for Herpes simplex virus (HSV) and enterovirus were selected. HPeV detection was performed with a commercially available real-time RT-PCR and HPeV strains from positive samples were subsequently genotyped by sequencing.

Results: HPeV RNA was detected in nine (7.5%) CSF samples. The median age of infected children was 41 days (range: 19-122 days). HPeV genotyping could be performed on five samples and three HPeV-3, one HPeV-1, and one HPeV-4 were identified. Hyperthermia associated with mottled skin was the predominant clinical presentation. Most clinical presentations of HPeV-infected infants were mild with a final diagnosis of sepsis-like illness. The median hospital stay was 3.5 days and five children received antibiotics.

Conclusion: Routine detection of HPeV in CSF may allow differential diagnosis of enterovirus infection and improve etiologic identification of sepsis-like illness in children.

Keywords: HPeV; cerebrospinal fluid; human parechovirus; sepsis-like illness.

MeSH terms

  • Cerebrospinal Fluid / virology*
  • Female
  • Genotype
  • Humans
  • Infant
  • Infant, Newborn
  • Length of Stay
  • Male
  • Parechovirus / genetics
  • Parechovirus / isolation & purification*
  • Picornaviridae Infections / diagnosis*
  • Picornaviridae Infections / virology
  • RNA, Viral / chemistry
  • Real-Time Polymerase Chain Reaction
  • Sepsis
  • Sequence Analysis, RNA

Substances

  • RNA, Viral