title: Characteristics and outcomes of human parechovirus infection in infants (2008-2012).
abstract: Human parechoviruses (HPeVs) cause a spectrum of disease ranging from self-limiting illness to severe disease and, sometimes, death. We describe the clinical characteristics and outcomes of HPeV infection in infants. The study describes the clinical and laboratory characteristics and outcomes of infants with HPeV infection during 2008-2012, from three paediatric hospitals in London each with a paediatric intensive care unit. The infants were retrospectively identified through laboratory and patient discharge databases and diagnosed through HPeV PCR. Fifty infants were identified. Half required admission to PICU. Infants less than 3 months were more likely to require PICU (16/25: p < 0.01). Clinical signs at presentation were often indistinguishable from those of bacterial sepsis and meningitis, but inflammatory markers were nearly always (95 % of cases) within normal ranges. Brain MRI showed white matter changes in 10/12 infants. Three of 19 infants with follow-up data (16 %) had significant neurological sequelae.
  
  
  CONCLUSIONS
  HPeV may cause severe disease and long-term neurological sequelae in young infants. HPeV should be considered in infants with clinical features of sepsis/meningitis with normal CSF microscopy. Prospective observational studies are warranted to better define the epidemiology of infection and thus inform future treatment trials.
authors.affiliation: Division of Clinical Science, Paediatric Infectious Diseases Research Group, St George's University of London, Jenner Wing, Level 2, Room 2.215E, Mail Point J2C, London, SW17 0RE, UK, stev@doctors.org.uk.
authors.forename: Stefania
authors.initials: S
authors.lastname: Vergnano
authors.forename: Seilesh
authors.initials: S
authors.lastname: Kadambari
authors.forename: Katrina
authors.initials: K
authors.lastname: Whalley
authors.forename: Esse N
authors.initials: EN
authors.lastname: Menson
authors.forename: Nuria
authors.initials: N
authors.lastname: Martinez-Alier
authors.forename: Mehrengise
authors.initials: M
authors.lastname: Cooper
authors.forename: Emile
authors.initials: E
authors.lastname: Sanchez
authors.forename: Paul T
authors.initials: PT
authors.lastname: Heath
authors.forename: Hermione
authors.initials: H
authors.lastname: Lyall
mesh_terms: D002547:Cerebral Palsy / Q000209:etiology; D005247:Feeding Behavior; D005260:Female; D005334:Fever / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D019934:International Normalized Ratio; D007508:Irritable Mood; D007805:Language Development Disorders / Q000209:etiology; D007902:Length of Stay / Q000706:statistics & numerical data; D053609:Lethargy / Q000209:etiology; D007964:Leukocytosis / Q000821:virology; D008111:Liver Function Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D009123:Muscle Hypotonia / Q000209:etiology; D009503:Neutropenia / Q000821:virology; D030061:Parechovirus; D010343:Patient Admission / Q000706:statistics & numerical data; D010850:Picornaviridae Infections / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D012189:Retrospective Studies; D012640:Seizures / Q000821:virology; D013921:Thrombocytopenia / Q000821:virology; D006113:United Kingdom / Q000453:epidemiology; D014786:Vision Disorders / Q000209:etiology; D066127:White Matter / Q000473:pathology