Distinct systemic and central nervous system disease patterns in enterovirus and parechovirus infected children
- PMID: 24662038
- DOI: 10.1016/j.jinf.2014.02.017
Distinct systemic and central nervous system disease patterns in enterovirus and parechovirus infected children
Abstract
Objectives: Enteroviruses (EV) and human parechoviruses (HPeV) infections are increasingly identified in neonates and young children with sepsis, meningitis and encephalitis. We investigated EV and HPeV viral loads in plasma and cerebrospinal fluid (CSF) among those presenting with sepsis or central nervous system (CNS) disease to gain understanding of the nature of these infections.
Methods: Detections frequencies and viral loads of EV and HPeV RNA were compared in plasma and CSF obtained from infected children originally identified on sepsis or CNS screening.
Results: Two distinct infection profiles were identified; 11 subjects with CNS disease, showed higher or similar viral loads in CSF than in plasma (median plasma:CSF ratio 0.5), whereas 14 children with sepsis showed low or undetectable viral loads in CSF and high viral loads in plasma (mean ratio 5700). HPeV type 3 and one EV serotype (coxsackievirus B2) were primarily associated with the latter presentation.
Conclusions: Simple detection of EV or HPeV RNA in CSF is not predictive of CNS disease, especially in the absence of clinical markers (i.e. pleocytosis). Screening of plasma can identify EV and HPeV RNA in a substantial proportion of sepsis cases, some of which will be missed if CSF samples alone are screened.
Keywords: Children; Enterovirus; Meningitis; Parechovirus; Picornavirus; Sepsis.
Copyright © 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
Similar articles
-
Outcome of routine cerebrospinal fluid screening for enterovirus and human parechovirus infection among infants with sepsis-like illness or meningitis in Cornwall, UK.Eur J Pediatr. 2018 Oct;177(10):1523-1529. doi: 10.1007/s00431-018-3209-8. Epub 2018 Jul 18. Eur J Pediatr. 2018. PMID: 30022279
-
Comparison of human parechovirus and enterovirus detection frequencies in cerebrospinal fluid samples collected over a 5-year period in edinburgh: HPeV type 3 identified as the most common picornavirus type.J Med Virol. 2011 May;83(5):889-96. doi: 10.1002/jmv.22023. J Med Virol. 2011. PMID: 21412796
-
Prevalence, type and concentration of human enterovirus and parechovirus in cerebrospinal fluid samples of pediatric patients over a 10-year period: a retrospective study.Virol J. 2015 Nov 25;12:199. doi: 10.1186/s12985-015-0427-9. Virol J. 2015. PMID: 26607060 Free PMC article.
-
Enterovirus and parechovirus infection in children: a brief overview.Eur J Pediatr. 2016 Aug;175(8):1023-9. doi: 10.1007/s00431-016-2725-7. Epub 2016 May 7. Eur J Pediatr. 2016. PMID: 27156106 Free PMC article. Review.
-
Enterovirus and parechovirus infections in children: differences in clinical presentation, mechanisms for meningitis without pleocytosis and mechanisms involved in the neurological outcome.Minerva Pediatr. 2019 Apr;71(2):150-158. doi: 10.23736/S0026-4946.18.05449-X. Epub 2018 Dec 3. Minerva Pediatr. 2019. PMID: 30511561 Review.
Cited by 13 articles
-
A European multicentre evaluation of detection and typing methods for human enteroviruses and parechoviruses using RNA transcripts.J Med Virol. 2020 Aug;92(8):1065-1074. doi: 10.1002/jmv.25659. Epub 2020 Jan 17. J Med Virol. 2020. PMID: 31883139 Free PMC article.
-
Parechovirus A Pathogenesis and the Enigma of Genotype A-3.Viruses. 2019 Nov 14;11(11):1062. doi: 10.3390/v11111062. Viruses. 2019. PMID: 31739613 Free PMC article. Review.
-
Polymerase chain reaction for human parechovirus on blood samples improves detection of clinical infections in infants.Mol Biol Rep. 2020 Jan;47(1):715-720. doi: 10.1007/s11033-019-05151-5. Epub 2019 Oct 28. Mol Biol Rep. 2020. PMID: 31659694
-
First reported case of Human Parechovirus encephalitis in an adult patient complicated by Refractory Status Epilepticus.IDCases. 2018 Dec 3;15:e00475. doi: 10.1016/j.idcr.2018.e00475. eCollection 2019. IDCases. 2018. PMID: 30591905 Free PMC article.
-
Assessment of blood enterovirus PCR testing in paediatric populations with fever without source, sepsis-like disease, or suspected meningitis: a prospective, multicentre, observational cohort study.Lancet Infect Dis. 2018 Dec;18(12):1385-1396. doi: 10.1016/S1473-3099(18)30479-1. Epub 2018 Oct 30. Lancet Infect Dis. 2018. PMID: 30389482 Free PMC article.
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources