Akturk Hacer, Sık Guntulu, Salman Nuran, Sutcu Murat, Tatli Burak, Ciblak Meral Akcay, Erol Oguz Bulent, Torun Selda Hancerli, Citak Agop, Somer Ayper
Department of Pediatrics, Pediatric Infectious Disease Unit, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Department of Pediatrics, Pediatric Intensive Care Unit, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
J Med Virol. 2015 Nov;87(11):1831-8. doi: 10.1002/jmv.24263. Epub 2015 Jun 12.
Human bocavirus (HBOV) has been reported as a worldwide distributed respiratory pathogen. It has also been associated with encephalitis recently by detection of the virus in cerebrospinal fluid (CSF) of patients presented with encephalitis. This retrospective study aimed to present clinical features of HBOV infections in children with respiratory symptoms and describe unexplained encephalopathy in a subgroup of these patients. Results of 1,143 pediatric nasal samples from mid-December 2013 to July 2014 were reviewed for detection of HBOV. A multiplex real time polymerase chain reaction assay was used for viral detection. Medical records of the patients were retrospectively analyzed. HBOV was detected in 30 patients (2.6%). Median age was 14 months (5-80). Clinical diagnoses were upper respiratory tract infection (n = 10), bronchopneumonia (n = 9), acute bronchiolitis (n = 5), pneumonia (n = 4), acute bronchitis (n = 1), and asthma execarbation (n = 1). Hospitalization was required in 16 (53.3%) patients and 10 (62.5%) of them admitted to pediatric intensive care unit (PICU). Noninvasive mechanical ventilation modalities was applied to four patients and mechanical ventilation to four patients. Intractable seizures developed in four patients while mechanically ventilated on the 2nd-3rd days of PICU admission. No specific reason for encephalopathy was found after a thorough investigation. No mortality was observed, but two patients were discharged with neurological sequela. HBOV may lead to respiratory infections in a wide spectrum of severity. This report indicates its potential to cause severe respiratory infections requiring PICU admission and highlights possible clinical association of HBOV and encephalopathy, which developed during severe respiratory infection.
人博卡病毒（HBOV）已被报道为一种在全球范围内传播的呼吸道病原体。最近，通过在患有脑炎的患者脑脊液（CSF）中检测到该病毒，它还与脑炎有关。这项回顾性研究旨在呈现患有呼吸道症状儿童的HBOV感染临床特征，并描述这些患者亚组中无法解释的脑病情况。对2013年12月中旬至2014年7月期间1143份儿科鼻拭子样本进行回顾，以检测HBOV。采用多重实时聚合酶链反应检测法进行病毒检测。对患者的病历进行回顾性分析。30名患者（2.6%）检测到HBOV。中位年龄为14个月（5 - 80个月）。临床诊断为上呼吸道感染（n = 10）、支气管肺炎（n = 9）、急性细支气管炎（n = 5）、肺炎（n = 4）、急性支气管炎（n = 1）和哮喘加重（n = 1）。16名（53.3%）患者需要住院治疗，其中10名（62.5%）入住儿科重症监护病房（PICU）。4名患者应用无创机械通气模式，4名患者应用机械通气。4名患者在入住PICU的第2 - 3天机械通气时出现难治性癫痫发作。经过全面调查，未发现脑病的具体原因。未观察到死亡病例，但有2名患者出院时伴有神经后遗症。HBOV可能导致广泛严重程度的呼吸道感染。本报告指出其有可能导致需要入住PICU的严重呼吸道感染，并强调了HBOV与脑病之间可能存在临床关联，这种关联在严重呼吸道感染期间出现。
