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June 20, 2014: Parechovirus and Neurologic Disease

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June 20, 2014

The advent of real-time reverse transcriptase PCR (RT-PCR) has allowed for improved detection of viral pathogens in meningitis and encephalitis. The human parechoviruses are an increasingly recognized cause of neurologic illness since the availability of commercial PCR testing. Parechovirus infection can result in a meningoencephalitis and has become a major pathogen in childhood, especially infants under three months of age (1). The prevalence of parechovirus in pediatric CSF samples ranges from 1-7%, and cases are not associated with significant CSF pleocytoses (2). Infections are seasonal, often occurring from late Spring through Fall (2). In comparison to CNS enterovirus infection, those with parechovirus are more likely to have altered mental status, seizures, and ataxia (2). 

References

  1. Harvala H, McLeish, N, Kondracka J, et al. Comparison of human parechovirus and enterovirus detection frequencies in cerebrospinal fluid samples collected over a 5-year period in Edinburgh: HPeV type 3 identified as the most common picornavirus type. J Med Virol 2011; 83: 889-896.
  2.  Felsenstein S, Yang S, Eubanks, N, et al. Human parechovirus central nervous system infections in Southern California children. Pediatr Infect Dis J 2013; epub ahead of print.   

Submitted by Adam Numis, MD.            

Dr. Numis is a member of the Resident and Fellow Section of Neurology.

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