title: Clinical characteristics of human parechoviruses 4-6 infections in young children.
abstract: BACKGROUND
  Human parechoviruses (HPeVs) and enteroviruses (EVs) belong to the family Picornaviridae. EVs are known to cause a wide range of disease such as meningitis, encephalitis, and sepsis. HPeV1 and 2 have been associated with mild gastrointestinal or respiratory symptoms in young children. HPeV3 is associated with more severe neonatal infection. Little is known about the epidemiology and pathology of HPeV4-6 in children.
  
  
  METHODS
  We evaluated the clinical symptoms of the children with an HPeV 4, 5, or 6 infection. The patients with positive HPeV4-6 in stool samples were selected and available plasma or cerebrospinal fluid samples from these patients were tested for HPeV. Data on clinical symptoms, diagnosis, presence and duration of fever, medical history, mean age, use of antibiotics of the children infected with HPeV4-6 were retrospectively documented.
  
  
  RESULTS
  HPeV4-6 were found in 31 of the 277 HPeV positive children (11%). Coinfection with EV was seen in 8 patients. Fever was seen in 13 (42%) patients. Of the HPeV4-6 positive patients, 20 of the 31 children (64%) presented with gastrointestinal complaints and 18 of 31 (58%) patients had respiratory symptoms. The mean age was 14 months, 58% of the patients had an underlying disorder such as bronchomalacia or a cardiac disorder.
  
  
  CONCLUSIONS
  Symptomatic HPeV4-6 infections are seen in relative young children and are associated with respiratory and/or gastrointestinal symptoms. HPeV type 4 was detected more frequently than HPeV types 5 and 6.
authors.affiliation: Department of Pediatric Infectious Diseases, Emma Children's Hospital, Amsterdam, The Netherlands. d.pajkrt@amc.uva.nl
authors.forename: Dasja
authors.initials: D
authors.lastname: Pajkrt
authors.forename: Kimberley S M
authors.initials: KS
authors.lastname: Benschop
authors.forename: Brenda
authors.initials: B
authors.lastname: Westerhuis
authors.forename: Richard
authors.initials: R
authors.lastname: Molenkamp
authors.forename: Louise
authors.initials: L
authors.lastname: Spanjerberg
authors.forename: Katja C
authors.initials: KC
authors.lastname: Wolthers
mesh_terms: D002555:Cerebrospinal Fluid / Q000821:virology; D002675:Child, Preschool; D015897:Comorbidity; D004769:Enterovirus Infections / Q000453:epidemiology; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D030061:Parechovirus / Q000145:classification / Q000302:isolation & purification*; D010850:Picornaviridae Infections / Q000453:epidemiology* / Q000473:pathology* / Q000503:physiopathology / Q000821:virology; D010949:Plasma / Q000821:virology; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology / Q000821:virology