title: Human Parechovirus Infections Associated with Seizures and Rash in Infants and Toddlers.
abstract: BACKGROUND
  Systematic investigations assessing the clinical impact of human parechovirus (HPeV) disease are sparse. Noninvasive stool samples may be useful for targeted hospital-based surveillance.
  
  
  METHODS
  In the context of a quality management program, all hospitalized children fulfilling predefined case criteria for central nervous system (CNS) infection/inflammation underwent standardized neurologic examinations. Stool samples were collected for HPeV and enterovirus (EV) polymerase chain reaction and molecular typing at the National Reference Center.
  
  
  RESULTS
  From October 2010 to December 2012, stool samples of 284 patients with suspected CNS infection/inflammation were tested yielding 12 (4.2%) HPeV+ samples and 43 (15.1%) EV+ samples. HPeV-positive samples included HPeV-1, HPeV-3 and HPeV-6. No additional pathogens were identified in routine care. HPeV-positive patients were significantly younger (P < 0.001) and more likely to present with seizures (P = 0.001) and rash (P < 0.0001) when compared with HPeV-negative patients.
  
  
  CONCLUSIONS
  In hospitalized children younger than 4 years presenting with suspected CNS infection/inflammation, seizures and/or rash, HPeV should be considered in the differential diagnosis. Large-scale public health surveillance may be indicated.
authors.affiliation: From the *Department of Pediatrics, Charité University Medical Center, Berlin, Germany; †Department of Mathematics and Computer Sciences, Freie Universitaet Berlin, Berlin, Germany; and ‡National Reference Center for Poliomyelitis and Enteroviruses, Robert Koch Institute, Berlin, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Karsch
authors.forename: Patrick
authors.initials: P
authors.lastname: Obermeier
authors.forename: Lea
authors.initials: L
authors.lastname: Seeber
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.forename: Franziska
authors.initials: F
authors.lastname: Tief
authors.forename: Susann
authors.initials: S
authors.lastname: Mühlhans
authors.forename: Christian
authors.initials: C
authors.lastname: Hoppe
authors.forename: Tim
authors.initials: T
authors.lastname: Conrad
authors.forename: Sindy
authors.initials: S
authors.lastname: Böttcher
authors.forename: Sabine
authors.initials: S
authors.lastname: Diedrich
authors.forename: Barbara
authors.initials: B
authors.lastname: Rath
mesh_terms: D005076:Exanthema / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D030061:Parechovirus; D010850:Picornaviridae Infections / Q000150:complications* / Q000453:epidemiology; D012189:Retrospective Studies; D012640:Seizures / Q000150:complications* / Q000453:epidemiology