A neonatal case of acute human parechovirus type 3 encephalopathy with being pathogen identified by the meningitis encephalitis multiplex PCR test

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  • 髄膜炎脳炎マルチプレックスPCRが診断に有用であったヒトパレコウイルス3型による急性脳症の新生児例

Abstract

Human parechovirus-3 (HPeV3) is one of the major causes of sepsis and encephalitis/encephalopathy in neonates. A multiplex PCR meningitis/encephalitis panel can perform PCR for multiple etiologic pathogens in one time. This case was a 14-day-old girl born at full term. She had a fever on 12 days of age, and after the fever resolved, she had episode of left hemispheric seizures and apnea. Ictal electroencephalogram showed rhythmic slow-wave discharges. Her blood tests showed elevated liver enzymes, coagulation abnormalities, and elevated ferritin. Cerebrospinal fluid analysis revealed no elevated protein and pleocytosis. Diffusion weighted image of brain MRI showed hyperintensity area in white matter and corpus callosum. HPeV derived nucleic acid was detected by the multiplex PCR meningitis/encephalitis panel. We made diagnosis of HPeV encephalopathy and underwent immunoglobulin therapy. HPeV3 DNA was detected in her blood, pharynx, cerebrospinal fluid after discharge from the hospital. Because symptoms caused by HPeV infection are nonspecific, the multiplex PCR meningitis/encephalitis panel is useful for early diagnosis.

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