Intracranial hemorrhage and other symptoms in infants associated with human parechovirus in Vienna, Austria

• Published in: European journal of pediatrics 2015-12, Vol.174 (12), p.1639-1647
• Main Authors: Kurz, Herbert, Prammer, Ruth, Bock, Wolfgang, Ollerieth, Robert, Bernert, Günther, Zwiauer, Karl, Aberle, Judith H., Aberle, Stephan W., Fazekas, Tamas, Holter, Wolfgang
• Format: Article
• Language: English
• Subjects: Austria - epidemiology; Central nervous system; Central Nervous System Infections - diagnosis; Central Nervous System Infections - epidemiology; Central Nervous System Infections - virology; Female; Fever; Genotypes; Hemorrhage; Humans; Illnesses; Infant; Infant, Newborn; Infants; Infections; Intracranial Hemorrhages - diagnosis; Intracranial Hemorrhages - epidemiology; Intracranial Hemorrhages - virology; Male; Medical records; Medicine; Medicine & Public Health; Neonates; Original Article; Parechovirus - isolation & purification; Patients; Pediatrics; Picornaviridae Infections - diagnosis; Picornaviridae Infections - epidemiology; Picornaviridae Infections - virology; Polymerase Chain Reaction; Retrospective Studies; RNA, Viral - genetics; Sepsis
• ISSN: 0340-6199; 1432-1076
• DOI: 10.1007/s00431-015-2583-8

The human parechovirus (HPeV), mainly genotype 3, may cause severe illness in young infants and neonates, including sepsis-like illness and central nervous system (CNS) infection. We lack data concerning the impact and symptoms of HPeV infection in infants in Austria. The aim of the study is to evaluate the spectrum of symptoms and findings in infants with the parechovirus in Vienna and its environs. Patients younger than 3 months of age, with clinically suspected sepsis-like illness or CNS infection and a positive polymerase chain reaction (PCR) for HPeV, were included in the study. Medical records were analyzed retrospectively. Twenty patients were included in the study from 2009 to 2013. The most frequent manifestations were fever and neurological symptoms (89 and 80 %, respectively). Fifty percent of the infants had white blood cell counts out of range. The most notable aspect was cerebral hemorrhage in three neonates, which has not been reported earlier in association with HPeV infection. Conclusion : In Austria, HPeV is a relevant pathogen in sepsis-like disease in infants. The clinical presentation is similar to that described in other studies; cerebral hemorrhage is a new aspect. What is Known: • Parechovirus infection can cause severe illness in infants. • Symptoms have been described to involve all organs; sepsis-like signs, fever, and irritability are most frequent. What is New: • Also in Austria, HPeV plays an important role in severe illnesses in infants. • Severe intracranial hemorrhage is described as a new finding.