Human Parechovirus Infection

Key Features

• Pathogen mainly affects small children although disease can also occur in older adults

• Cases are spread worldwide

• There are 19 recognized genotypes

Clinical Findings

• Gastrointestinal and respiratory illness

• Otitis

• Neonatal sepsis

• Fever without a detectable source

• Gastroenteritis

• Flaccid paralysis

• Myalgias (which may be epidemic)

• Diffuse maculopapular and palmar-plantar rashes

• Aseptic meningitis

• Intracranial hemorrhage

• Seizures

• Pericarditis

• Acute disseminated encephalitis

Diagnosis

• Polymerase chain reaction (PCR) helps determine the viral cause of neonatal sepsis or central nervous system (CNS) symptoms in children younger than 5 years

• Stool and nasopharyngeal samples

• Cerebrospinal fluid samples for CNS-related infections

Treatment

• Supportive

• Intravenous immunoglobulin was anecdotally successful in one case of parechovirus dilated cardiomyopathy