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Human parechovirus-3 infection in nine neonates and infants presenting symptoms of hemophagocytic lymphohistiocytosis

  • Case Report
  • Published:
Journal of Infection and Chemotherapy

Abstract

Human parechovirus-3 (HPeV-3) has been reported to cause a sepsis-like illness in neonates and young infants. We experienced the occurrence of HPeV-3 infection in nine neonates and young infants (eight boys, one girl; aged 14–52 days, median 31 days). They were admitted to our hospital with the chief complaints of fever persisting for 3–5 days (median 4 days) and lethargy. Five infants presented with abdominal distension and six had a rash (including acral reddening), as was previously reported with this viral infection. Abdominal distension with navel protrusion and acral reddening during the course were characteristic. Laboratory data were characterized by elevated values for serum AST, LDH, FDP, D-dimer, ferritin, soluble IL-2 receptor, triglyceride, choline esterase, and urinary β2-microglobulin. Two of our nine patients presented with a hemophagocytic lymphohistiocytosis (HLH)-like illness and required specific therapy. These data suggest that HPeV-3 is an important virus that can cause hypercytokinemia, which sometimes leads to HLH, and systemic inflammatory response syndrome in neonates and young infants.

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Acknowledgments

We thank Dr. S. Usuku (Yokohama City Institute of Publish Health) for the isolation of viruses.

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Authors and Affiliations

  1. Department of Pediatrics, Saiseikai Yokohamashi Nanbu Hospital, 3-2-10 Konandai, Konan-ku, Yokohama, Kanagawa, 234-8503, Japan

    Saeko Shimodera Yuzurihara, Fumiko Tanaka & Sumio Kai

  2. Department of Pediatrics, Yokohama City Minato Red Cross Hospital, Yokohama, Japan

    Kota Ao & Nobuyuki Kikuchi

  3. Department of Pediatrics, Yokohama City University Medical Center, Yokohama, Japan

    Takuma Hara & Masaaki Mori

  4. Department of Pediatrics, Yokohama City University School of Medicine, Yokohama, Japan

    Shumpei Yokota

Authors
  1. Saeko Shimodera Yuzurihara
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  2. Kota Ao
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  3. Takuma Hara
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  4. Fumiko Tanaka
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  5. Masaaki Mori
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  6. Nobuyuki Kikuchi
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  7. Sumio Kai
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  8. Shumpei Yokota
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Correspondence to Saeko Shimodera Yuzurihara.

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Yuzurihara, S.S., Ao, K., Hara, T. et al. Human parechovirus-3 infection in nine neonates and infants presenting symptoms of hemophagocytic lymphohistiocytosis. J Infect Chemother 19, 144–148 (2013). https://doi.org/10.1007/s10156-012-0420-9

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  • DOI: https://doi.org/10.1007/s10156-012-0420-9

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