Unexpected detection of human parechovirus in infants with suspected meningitis using real-time multiplex PCR

Human parechovirus meningitis in children: state of the art

“…Almost all reports showed that the youngest (under 3 months of age and in particular neonates) were the most affected patients. [ 9 – 12 , 14 , 21 , 23 , 26 – 28 , 32 , 33 , 59 – 62 , 64 – 68 , 70 ]. Of note, an exceptional adolescent onset was reported in an immunosuppressed 17-year-old girl [ 58 ].…”

“…Fever was the most frequent presenting sign [ 1 , 41 , 44 – 47 , 49 , 50 , 52 – 58 ]. In fact, fever occurrence ranged between 80% and 100% [ 8 , 10 – 12 , 14 , 17 , 21 , 23 , 25 – 28 , 32 , 33 , 60 – 64 , 69 , 70 ]. However, in an American retrospective study, 2% of patients reported hypothermia (TC < 35 °C) instead of hyperthermia [ 68 ].…”

“…Other frequent symptoms included irritability, from 40 to 100%, poor feeding, from 42 to 81.8%, and tachycardia ranging from 63.6 to 77% [ 12 , 14 , 26 , 41 , 44 – 46 , 51 – 54 , 58 , 60 , 62 – 64 , 67 – 70 ]. In a few cases lethargy was the presenting symptom, with a prevalence between 14% and 51% [ 1 , 12 , 14 , 26 , 60 , 69 ].…”

“…Many clinical cases of HPeV CNS infection included a cutaneous sign, as macular or maculo-papular rash, involving mainly truncus and extremities [ 14 , 23 , 41 , 45 , 47 , 54 – 58 , 62 ]. The occurrence of a rash as a presenting sign ranged from 20 to 60% [ 1 , 8 , 11 , 12 , 17 , 21 , 52 , 53 , 60 , 64 , 68 , 69 ].…”

“…Other symptoms involving the respiratory system have been described, including coryza, cough, breathing difficulties, apnea and tachypnea. Their reported occurrence varied from 37.5 to 18.2% [ 11 , 64 , 68 , 70 ].…”