Human parechovirus: sepsis-like illness with pulmonary infection

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چکیده

Human parechoviruses (HPeV), previously designated as echovirus 22 and 23, belong to the Parechovirus genus within the Picornaviridae family and has been designated HPeV 1 and 2 respectively.1 The HPeV genome organization and disease spectrum are similar to other viruses in the Picornaviridae family. HPeV have been frequently associated with respiratory and gastrointestinal diseases in children and severe disease in neonates that includes sepsis, meningitis, encephalitis, and hepatitis.2 In Brazil, HPeV type 8 was first reported in a gastroenteritis outbreak, where 35 stool samples were analyzed and 16.1% were HPeV positive.3 Highlighting HPeV as etiology of respiratory infection, the authors report the case of a 2-yearold girl with signs and symptoms of sepsis-like illness which progressed to sepsis with pulmonary focus. She was admitted to the pediatric emergency unit in a tertiary care hospital in Southern Brazil, with previous history of rhinorrhea, otorrhea and fever for seven days, and dry cough, poor food acceptance and emesis with grunting episodes in the three days prior to admission. Previously, the patient had two hospitalizations for pneumonia at the age of eight and 15 months. The mother reported meningitis outbreak at the patient’s daycare 15 days before, and the child had the vaccination protocol updated. Upon admission, the patient weighed 13 kg, had tachycardia (175 beats/min) and tachypnea (33 breaths/min), was in poor general condition, whining, pale, sleepy, with reduced vesicular murmur, fine crackles and dullness to percussion of left pulmonary lower medium-third. The lung ultrasound showed a small pleural effusion of 0.5 cm thick, with no need of drainage. The patient progressed with respiratory insufficiency, altered consciousness level and septic shock requiring ICU monitoring and mechanical ventilation and her oxygen saturation was 91%. The patient had hemodynamic instability, requiring vasoactive drugs, metabolic acidosis and altered renal function. X-rays showed an acute respiratory distress syndrome (ARDS) pattern (Fig. 1), with bronchopneumonia and pulmonary edema; progressed with decreased urine output and worsening of urea and creatinine levels compared Fig. 1 – X-ray reveals an acute respiratory distress syndrome (ARDS).

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منابع مشابه

Nosocomial Outbreak of Parechovirus 3 Infection among Newborns, Austria, 2014

In 2014, sepsis-like illness affected 9 full-term newborns in 1 hospital in Austria. Although results of initial microbiological testing were negative, electron microscopy identified picornavirus. Archived serum samples and feces obtained after discharge were positive by PCR for human parechovirus 3. This infection should be included in differential diagnoses of sepsis-like illness in newborns.

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Two cases of sepsis-like illness in infants caused by human parechovirus traced back to elder siblings with mild gastroenteritis and respiratory symptoms.

Sepsis and sepsis-like illness in neonates and infants are serious emergencies. Recently, human parechovirus type 3 (HPeV-3) has been identified as a further etiologic agent of these conditions. We report two unlinked cases of infant HPeV-3 sepsis-like illness whose sources could be traced back to elder siblings with mild gastroenteritis and respiratory symptoms.

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Prevalence of human parechovirus and enterovirus in cerebrospinal fluid samples in children in Jinju, Korea

PURPOSE Human parechovirus (HPeV) and enterovirus (EV) are causative agents of a sepsis-like illness in neonates and of infections of the central nervous system in young children. The objectives of this study were to assess the prevalence of HPeV3 and EV infection in young children with a sepsis-like illness or with meningitis in Jinju, Korea. METHODS Cerebrospinal fluid (CSF) samples were co...

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Human parechovirus: sepsis-like illness with pulmonary infection

Human parechoviruses (HPeV), previously designated as echovirus 22 and 23, belong to the Parechovirus genus within the Picornaviridae family and has been designated HPeV 1 and 2 respectively.1 The HPeV genome organization and disease spectrum are similar to other viruses in the Picornaviridae family. HPeV have been frequently associated with respiratory and gastrointestinal diseases in children...

متن کامل

Human parechovirus: sepsis-like illness with pulmonary infection

Human parechoviruses (HPeV), previously designated as echovirus 22 and 23, belong to the Parechovirus genus within the Picornaviridae family and has been designated HPeV 1 and 2 respectively.1 The HPeV genome organization and disease spectrum are similar to other viruses in the Picornaviridae family. HPeV have been frequently associated with respiratory and gastrointestinal diseases in children...

متن کامل

Human parechovirus: sepsis-like illness with pulmonary infection

Human parechoviruses (HPeV), previously designated as echovirus 22 and 23, belong to the Parechovirus genus within the Picornaviridae family and has been designated HPeV 1 and 2 respectively.1 The HPeV genome organization and disease spectrum are similar to other viruses in the Picornaviridae family. HPeV have been frequently associated with respiratory and gastrointestinal diseases in children...

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تاریخ انتشار 2017