Key result
Human parechovirus infection in children and infants was associated with a significantly lower cerebrospinal fluid white blood cell count compared to enterovirus infection, even after adjusting for age and sex.
Why the study?
Enteroviruses and human parechoviruses cause fever in young infants and meningitis in children with similar symptoms, prompting a comparison of their clinical characteristics.
What are the clinical and laboratory differences between Enterovirus and Human Parechovirus infections in young children and infants?
Observational (n=50)
No
What are the clinical and laboratory differences between Enterovirus and Human Parechovirus infections in young children and infants?
Mean Difference: -259.5 (95% CI -471.8–-47.2)
Absolute Event Rate: 2% vs 30%
p-value: p=0.018
While clinical characteristics of HPeV and EV infections are generally similar, HPeV presents in younger patients with lower white blood cell counts, whereas EV is associated with more headaches.
May aid differentiation of HPeV from EV CNS infection in infants; leaves open need for prospective validation before changing practice.
Purpose: Enteroviruses (EVs) and human parechoviruses (HPeVs) are important pathogens that cause fever in young infants and meningitis in children and have similar clinical symptoms and characteristics. The aim of this study was to compare the clinical symptoms and characteristics of EV and HPeV infections in young children and infants. Methods: From June to August 2018, we obtained 50 cerebrospinal fluid (CSF) samples, of which 36 and 14 were EV-and HPeV-positive, respectively, as determined by film array methods. We then compared the clinical characteristics and laboratory values of patients with EV and HPeV infections. Results: HPeV patients had a lower age than EV patients, but had similar sex predominance and fever duration. Moreover, EV patients had a higher prevalence of headache and mannitol use than HPeV patients. The blood and CSF white blood cell counts were lower among HPeV patients even after adjusting for sex and age. Furthermore, both viruses were found to cause occasional transient white matter injuries in the brain. Conclusion: The clinical characteristics of HPeV and EV infections were found to be generally similar, but with a few noteworthy differences.
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Seonkyeong Rhie (2019) conducted an observational in Meningoencephalitis / Aseptic meningitis (n=50). Human parechovirus (HPeV) infection vs. Enterovirus (EV) infection was evaluated on Cerebrospinal fluid (CSF) white blood cell (WBC) count (/mm3) (MD -259.5, 95% CI -471.8 to -47.2, p=0.018). Human parechovirus infection in children and infants was associated with a significantly lower cerebrospinal fluid white blood cell count compared to enterovirus infection, even after adjusting for age and sex.
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