title: Epidemiology and clinical characteristics of infants with human parechovirus or human herpes virus-6 detected in cerebrospinal fluid tested for enterovirus or herpes simplex virus.
abstract: Human parechovirus (HPeV) and human herpes virus-6 (HHV-6) are acquired commonly in infancy and associated with central nervous system infection. The prevalence of HPeV and HHV-6 in the cerebrospinal fluid (CSF) of infants tested for enterovirus (EV) and herpes-simplex virus (HSV) is unknown. All stored CSF samples from EV or HSV testing in infants less than 6 months of age at Children's Hospital Colorado between January 1, 2010 and December 31, 2011 were tested for HPeV, HHV-6, EV, and HSV by PCR. Clinical characteristics and epidemiological data were collected using retrospective electronic chart review. Of 239 infants tested, 29 cases of EV (12.1%), 7 cases of HPeV (2.9%), 5 cases of HHV-6 (2.1%), and 5 cases of HSV (2.1%) were identified with no bacterial co-infections. HPeV cases occurred between July and October in infants with median age of 24 days. Infants with HPeV had a median maximum temperature of 39 °C, median fever duration of 3 days and median peripheral white blood cell count of 5.2 × 10(3)/μL. HHV-6 cases occurred in infants with median age of 61 days without seasonality. Five percent of infants less than 6 months of age undergoing testing for EV or HSV have HPeV or HHV-6 in the CSF. Targeting testing of HPeV towards febrile infants less than 2 months of age with leukopenia in the late summer to early fall, and HHV-6 towards older infants may increase diagnostic yield. The clinical and fiscal impact of testing infants for HPeV and HHV-6 needs to be determined.
authors: Department of Pediatrics, Section of Hospital Medicine and Infectious Diseases, Aurora, Colorado; Department of Pathology and Laboratory Medicine, Aurora, Colorado.
authors: Kevin
authors: K
authors: Messacar
authors: Garrett
authors: G
authors: Breazeale
authors: Qi
authors: Q
authors: Wei
authors: Christine C
authors: CC
authors: Robinson
authors: Samuel R
authors: SR
authors: Dominguez
mesh_terms: D002555:Cerebrospinal Fluid / Q000821:virology*; D003120:Colorado / Q000453:epidemiology; D018792:Encephalitis, Viral / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D004770:Enterovirus / Q000302:isolation & purification; D004769:Enterovirus Infections / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D005260:Female; D006566:Herpesviridae Infections / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D015654:Herpesvirus 6, Human / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D030061:Parechovirus / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012621:Seasons; D018139:Simplexvirus / Q000302:isolation & purification; D013696:Temperature
keywords: aseptic meningitis; enterovirus; herpes simplex virus; human herpes virus 6; human parechovirus; suspected sepsis