BACKGROUND: Human parechovirus type 3 (HPeV3) infection can cause sepsis-like syndrome and meningoencephalitis in neonates and young infants. Although maculopapular rash is a reported clinical manifestation of HPeV3 infection, the frequency and detailed characteristics of rash in neonates and young infants with HPeV3 infection are unknown. METHODS: We retrospectively reviewed the clinical characteristics of neonates and young infants who received a diagnosis of HPeV3 infection on the basis of real-time polymerase chain reaction analysis of serum and/or cerebrospinal fluid specimens at the National Center for Child Health and Development in Tokyo between November 2010 and September 2011. RESULTS: Fifteen neonates and young infants were diagnosed as having HPeV3 infection; median age was 33 days (range: 10-81 days). The most common clinical presentation on admission was fever (80%), the median duration of which was 3 days (range: 1-4 days). Five (33%) children required admission to the intensive care unit for close observation, and 2 (13%) required mechanical ventilation for cardiovascular instability. After hospitalization, all children developed rash, mainly on the extremities, at a mean of 3 days (range: 1-5 days) after fever onset. The most striking finding was that 80% (12/15) of patients developed a distinctive palmar-plantar erythematous rash, which disappeared after a median of 3 days (range: 2-7 days). All patients were discharged from hospital without serious sequelae. CONCLUSIONS: Palmar-plantar erythema in febrile neonates and young infants may be a diagnostic clue of HPeV3 infection.
BACKGROUND:Human parechovirus type 3 (HPeV3) infection can cause sepsis-like syndrome and meningoencephalitis in neonates and young infants. Although maculopapular rash is a reported clinical manifestation of HPeV3 infection, the frequency and detailed characteristics of rash in neonates and young infants with HPeV3 infection are unknown. METHODS: We retrospectively reviewed the clinical characteristics of neonates and young infants who received a diagnosis of HPeV3 infection on the basis of real-time polymerase chain reaction analysis of serum and/or cerebrospinal fluid specimens at the National Center for Child Health and Development in Tokyo between November 2010 and September 2011. RESULTS: Fifteen neonates and young infants were diagnosed as having HPeV3 infection; median age was 33 days (range: 10-81 days). The most common clinical presentation on admission was fever (80%), the median duration of which was 3 days (range: 1-4 days). Five (33%) children required admission to the intensive care unit for close observation, and 2 (13%) required mechanical ventilation for cardiovascular instability. After hospitalization, all children developed rash, mainly on the extremities, at a mean of 3 days (range: 1-5 days) after fever onset. The most striking finding was that 80% (12/15) of patients developed a distinctive palmar-plantar erythematous rash, which disappeared after a median of 3 days (range: 2-7 days). All patients were discharged from hospital without serious sequelae. CONCLUSIONS:Palmar-plantar erythema in febrile neonates and young infants may be a diagnostic clue of HPeV3 infection.
Authors: María Cabrerizo; Gloria Trallero; María José Pena; Amaia Cilla; Gregoria Megias; Carmen Muñoz-Almagro; Eva Del Amo; Diana Roda; Ana Isabel Mensalvas; Antonio Moreno-Docón; Juan García-Costa; Nuria Rabella; Manuel Omeñaca; María Pilar Romero; Sara Sanbonmatsu-Gámez; Mercedes Pérez-Ruiz; María José Santos-Muñoz; Cristina Calvo Journal: Eur J Pediatr Date: 2015-05-16 Impact factor: 3.183
Authors: Grace P K Chiang; Zigui Chen; Martin C W Chan; Simon H M Lee; Angela K Kwok; Apple C M Yeung; E Anthony S Nelson; Kam Lun Hon; Ting Fan Leung; Paul K S Chan Journal: PLoS One Date: 2017-09-08 Impact factor: 3.240