title: Severe human parechovirus type 3 myocarditis and encephalitis in an adolescent with hypogammaglobulinemia.
abstract: Human parechovirus (HPeV) belongs to the Picornaviridae family of RNA viruses. HPeV infections can be asymptomatic, lead to mild respiratory and/or gastrointestinal symptoms, or less frequently cause severe diseases such as sepsis, meningitis, encephalitis, and myocarditis. Severe neurological HPeV infections occur most commonly in infants and neonates. There are currently 16 recognized types of HPeV. HPeV type 3 (HPeV3) has been the predominant type associated with severe central nervous system disease in neonates and newborns since its discovery in 1999. Although HPeV-related infections have been reported in adults, symptomatic HPeV3 infections in adolescents and adults are uncommon. A case of severe HPeV3 myocarditis and encephalitis in an adolescent is described.
authors.affiliation: Department of Pathology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: Stacey K
authors.initials: SK
authors.lastname: Mardekian
authors.affiliation: Department of Pathology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Fortuna
authors.affiliation: Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Allan
authors.initials: A
authors.lastname: Nix
authors.affiliation: Department of Pathology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
authors.forename: Tricia
authors.initials: T
authors.lastname: Bhatti
authors.affiliation: Department of Pathology, UPMC Presbyterian Hospital, Pittsburgh, Pennsylvania, USA.
authors.forename: Clayton A
authors.initials: CA
authors.lastname: Wiley
authors.affiliation: Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Flanders
authors.affiliation: Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Urtecho
authors.affiliation: Department of Rheumatology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sloane
authors.affiliation: Department of Rheumatology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: Jowairiyya
authors.initials: J
authors.lastname: Ahmad
authors.affiliation: Department of Pathology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: Mark T
authors.initials: MT
authors.lastname: Curtis
mesh_terms: D000293:Adolescent; D000361:Agammaglobulinemia / Q000150:complications*; D018792:Encephalitis, Viral / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D009205:Myocarditis / Q000175:diagnosis* / Q000821:virology; D010850:Picornaviridae Infections / Q000150:complications / Q000175:diagnosis*
keywords: Encephalitis; Flaccid paralysis; Human parechovirus; Hypogammaglobulinemia; Myocarditis; Rituximab