Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Distinctive clinical features of HPeV-3 infection in 2 neonates with a sepsis-like illness

  • Yeom, Jung Sook (Department of Pediatrics, Gyeongsang National University School of Medicine) ;
  • Park, Ji Sook (Department of Pediatrics, Gyeongsang National University School of Medicine) ;
  • Seo, Ji-Hyun (Department of Pediatrics, Gyeongsang National University School of Medicine) ;
  • Park, Eun Sil (Department of Pediatrics, Gyeongsang National University School of Medicine) ;
  • Lim, Jae-Young (Department of Pediatrics, Gyeongsang National University School of Medicine) ;
  • Park, Chan-Hoo (Department of Pediatrics, Gyeongsang National University School of Medicine) ;
  • Woo, Hyang-Ok (Department of Pediatrics, Gyeongsang National University School of Medicine) ;
  • Youn, Hee-Shang (Department of Pediatrics, Gyeongsang National University School of Medicine) ;
  • Lee, Ok Jeong (Department of Pediatrics, Sejong General Hospital) ;
  • Han, Tae-Hee (Department of Laboratory Medicine, Inje University Sanggyepaik Hospital, Inje University College of Medicine) ;
  • Chung, Ju-Young (Department of Pediatrics, Inje University Sanggyepaik Hospital, Inje University College of Medicine)
  • 투고 : 2016.02.03
  • 심사 : 2016.05.16
  • 발행 : 2016.07.15
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초록

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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참고문헌

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피인용 문헌

  1. Clinical Differences between Enterovirus and Human Parechovirus in Children and Infants vol.28, pp.1, 2016, https://doi.org/10.26815/acn.2019.00227
  2. Acral manifestations associated with infection vol.38, pp.6, 2016, https://doi.org/10.1111/pde.14831