title: Relevance of human parechovirus detection in cerebrospinal fluid samples from young infants with sepsis-like illness.
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.
  
  
  CONCLUSIONS
  Routine detection of HPeV in CSF may allow differential diagnosis of enterovirus infection and improve etiologic identification of sepsis-like illness in children.
authors.affiliation: Department of Pediatrics, Montpellier University Hospital, Montpellier, France; INSERM U1058, Montpellier 1 University, Montpellier, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Jeziorski
authors.forename: Isabelle
authors.initials: I
authors.lastname: Schuffenecker
authors.forename: Sandrine
authors.initials: S
authors.lastname: Bohrer
authors.forename: Jean Baptiste
authors.initials: JB
authors.lastname: Pain
authors.forename: Michel
authors.initials: M
authors.lastname: Segondy
authors.forename: Vincent
authors.initials: V
authors.lastname: Foulongne
mesh_terms: D002555:Cerebrospinal Fluid / Q000821:virology*; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D030061:Parechovirus / Q000235:genetics / Q000302:isolation & purification*; D010850:Picornaviridae Infections / Q000175:diagnosis* / Q000821:virology; D012367:RNA, Viral / Q000737:chemistry; D060888:Real-Time Polymerase Chain Reaction; D018805:Sepsis; D017423:Sequence Analysis, RNA
chemical_list: D012367:RNA, Viral
keywords: HPeV; cerebrospinal fluid; human parechovirus; sepsis-like illness