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KMID : 1130320160590070308
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Korean Journal of Pediatrics
2016 Volume.59 No. 7 p.308 ~ p.311
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Distinctive clinical features of HPeV-3 infection in 2 neonates with a sepsis-like illness
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Yeom Jung-Sook
Park Ji-Sook
Seo Ji-Hyun
Park Eun-Sil
Lim Jae-Young
Park Chan-Hoo
Woo Hyang-Ok
Youn Hee-Shang
Lee Ok-Jeong
Han Tae-Hee
Chung Ju-Young
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Abstract
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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.
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KEYWORD
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Parechovirus , Newborn , Exanthema , Ferritins
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