Human parechovirus type 5 neurological infection in a neonate with a favourable outcome: A case report

Antonio Piralla, Simona Perniciaro, Serena Ossola, Federica Giardina, Agnese De Carli, Angela Bossi, Massimo Agosti, Fausto Baldanti

Research output: Contribution to journalArticle

Abstract

The majority of parechovirus A type 5 (PeV-A5) infections have been reported in patients with gastrointestinal syndromes. In contrast, a sepsis-like illness associated with PeV-A5 infection has been reported only anecdotally. Herein, we report the first case in Italy of a PeV-A5 neurological infection presenting in a neonate with a sepsis-like syndrome. The patient, a healthy male infant born at 41 weeks of gestation, was highly distressed and inconsolable, and had been crying persistently, with poor breastfeeding, since the previous day. From day 2 to day 4, the newborn was feverish with mild irritability; breastfeeding was preserved and regularly supported. His clinical condition progressively improved, with defervescence on day 4. He was discharged after 7 days, and neurological examination results indicated only mild impairment in visual fixation and vertical eye tracking and mild axial hypotonia. The Italian PeV-A5 strain was phylogenetically related to three strains detected in Denmark in 2012, as well as to one detected in Australia and one in Greece in 2015, with an average nucleotide identity of 97.9% (range 95.9–100.0%). Enterovirus/PeV infection in the newborn should be ruled out in cases of infants with unexplained fever and/or a sepsis-like syndrome and/or meningoencephalitis. An aetiological diagnosis is essential to avoid the unnecessary administration of antibiotics and to plan long-term follow-up until schooling.

Original languageEnglish
Pages (from-to)175-178
Number of pages4
JournalInternational Journal of Infectious Diseases
Volume89
DOIs
Publication statusPublished - Dec 2019

Keywords

  • CNS infection
  • CSF
  • Human parechovirus type 5
  • Molecular characterization
  • Neonatal infections
  • Phylogenetic analysis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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