Distinctive clinical features of HPeV-3 infection in 2 neonates with a sepsis-like illness.
10.3345/kjp.2016.59.7.308
- Author:
Jung Sook YEOM
1
;
Ji Sook PARK
;
Ji Hyun SEO
;
Eun Sil PARK
;
Jae Young LIM
;
Chan Hoo PARK
;
Hyang Ok WOO
;
Hee Shang YOUN
;
Ok Jeong LEE
;
Tae Hee HAN
;
Ju Young CHUNG
Author Information
1. Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.
- Publication Type:Case Report
- Keywords:
Parechovirus;
Newborn;
Exanthema;
Ferritins
- MeSH:
Aspartate Aminotransferases;
Cerebrospinal Fluid;
Erythema;
Exanthema;
Ferritins;
Fever;
Humans;
Immunoglobulins;
Infant, Newborn*;
L-Lactate Dehydrogenase;
Parechovirus;
Virology
- From:Korean Journal of Pediatrics
2016;59(7):308-311
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report a human parechovirus-3 (HPeV-3) infection in 2 neonates who had prolonged fever (>5 days) with palmar-plantar erythema. This distinctive rash was observed 4–5 days after fever onset, just before defervescence. Elevated aspartate aminotransferase, lactate dehydrogenase, and ferritin levels were characteristic laboratory findings in the 2 cases, suggesting tissue damage caused by hypercytokinemia. Case 1 was treated with intravenous immunoglobulin, considering the possibility of severe systemic inflammatory responses. The initial ferritin level was 385 ng/mL (range, 0–400 ng/mL); however, the level increased to 2,581 ng/dL on day 5 after fever onset. Case 2 presented with milder clinical symptoms, and the patient recovered spontaneously. HPeV-3 was detected in cerebrospinal fluid and/or blood samples, but no other causative agents were detected. The findings from our cases, in accordance with recent studies, suggest that clinical features such as palmar-plantar erythema and/or hyperferritinemia might be indicators of HPeV-3 infection in neonates with sepsis-like illness. In clinical practice, where virology testing is not easily accessible, clinical features such as palmar-plantar erythema and/or hyperferritinemia might be helpful to diagnose HPeV-3 infection.
