LAUSR

Aims Presentation of Human Parechovirus (HPeV) in infants is often indistinguishable from those of bacterial sepsis and meningitis. Methods We describe recent HPeV infection in 4 infants. Results All 4 infants required a fluid bolus due to poor circulation. 2 babies had blanching maculopapular rash. Initial investigations in all cases showed a normal white cell count and CRP; bacterial cultures showed no growth; the cerebrospinal fluid PCR in all cases confirmed Parechovirus infection. All cases were young infants with varying illness as follows: Abstract G241(P) Table 1 Case Presentation Broad spectrum antibiotics Acyclovir Outcome 1 2-week-old boy with reduced intake, irritability, pyrexia and diarrhoea. He was mottled and had a widespread blanching rash. Yes Yes Normal development at 5 months 2 5-week-old girl with pyrexia and irritability. Coryzal symptoms for 3 weeks. She was mottled with a maculopapular rash on torso and had increased work of breathing. Yes No Normal development at 4 months age 3 2-week-old boy with pyrexia, irritability and reduced intake. He was irritable, had abdominal distension and persistent tachycardia. He was transferred to a tertiary centre for possible abdominal sepsis. Yes Yes Normal development at 5 months 4 7-day-old boy with fever, irritability, vomiting and rash. He had widespread papular rash with erythema at axillae and poor perfusion. Yes Yes No health issues at 2 months age. Conclusion An unusually high number of cases of parechovirus meningitis in infants have been reported in the United Kingdom during summer 2016. Young infants are particularly susceptible to aseptic HPeV meningitis and often present with non-specific symptoms that are difficult to differentiate from serious bacterial infections. Most infants develop mild, self-limiting symptoms such as fever or rash, but some may progress to life-threatening illnesses including meningitis and multi-organ failure. HPeV have also been shown to cause extensive cerebral white matter damage resulting in developmental delay, cerebral palsy and epilepsy.