Sano Kentaro, Hamada Hiromichi, Hirose Shoko, Sugiura Kenta, Harada Satoko, Koizumi Mai, Hara Mayumi, Nishijima Haruna, Taira Masakatsu, Ogura Atsushi, Ogawa Tomoko, Takanashi Jun-Ichi
Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Chiba, Japan.
Division of Virology, Chiba Prefectural Institute of Public Health, Chuou, Chiba, Japan.
Pediatr Int. 2018 Feb;60(2):142-147. doi: 10.1111/ped.13467.
Human parechovirus (HPeV) and human non-polio enterovirus (EV) are important causes of fever without source (FWS) in young infants. Their prevalence and clinical characteristics are largely unknown in Asian countries. This study was conducted to elucidate the epidemiology and clinical characteristics of HPeV and EV infection in febrile young infants in Japan.
During February 2010-August 2015, we obtained 53 stool, 44 throat swab, and 20 cerebrospinal fluid samples from 56 infants (<3 months) with FWS at a single hospital. To each sample, we applied reverse transcription-polymerase chain reaction for HPeV and EV. We compared the clinical characteristics of HPeV and EV patients.
HPeV was detected in 11 and EV in 17 patients. HPeV was detected during July-September. HPeV patients, compared with EV patients, had lower age (32 vs 47 days; P = n.s.), higher prevalence of exclusive breast-feeding (81.8 vs 29.4%; P = 0.024), and lower prevalence of sick contacts (36.4 vs 88.2%; P = 0.010). More HPeV than EV patients met the systemic inflammatory response syndrome criteria (90.9 vs 52.9%; P = 0.049). In the HPeV group, leukopenia, thrombopenia, and elevated deviation enzyme were observed, although the prevalence of abnormal cerebrospinal fluid was significantly lower than in the EV group. HPeV patients had longer hospital stay (7 vs 5 days; P = 0.025).
HPeV and EV are important causal viruses of FWS. Characteristic clinical pictures exist in these virus infections, but further research is needed to accumulate more cases to produce a comprehensive picture of these virus infections.
人细小病毒（HPeV）和人非脊髓灰质炎肠道病毒（EV）是导致小婴儿不明原因发热（FWS）的重要病因。在亚洲国家，它们的流行情况和临床特征大多未知。本研究旨在阐明日本发热小婴儿中HPeV和EV感染的流行病学及临床特征。
2010年2月至2015年8月期间，我们从一家医院的56例不明原因发热的婴儿（<3个月）中获取了53份粪便、44份咽拭子和20份脑脊液样本。对每份样本应用针对HPeV和EV的逆转录-聚合酶链反应。我们比较了HPeV和EV患者的临床特征。
11例患者检测到HPeV，17例患者检测到EV。HPeV在7月至9月期间被检测到。与EV患者相比，HPeV患者年龄更小（32天对47天；P值无统计学意义），纯母乳喂养的患病率更高（81.8%对29.4%；P = 0.024），有患病接触史的患病率更低（36.4%对88.2%；P = 0.010）。符合全身炎症反应综合征标准的HPeV患者比EV患者更多（90.9%对52.9%；P = 0.049）。在HPeV组中，观察到白细胞减少、血小板减少和转氨酶升高，尽管脑脊液异常的患病率显著低于EV组。HPeV患者住院时间更长（7天对5天；P = 0.025）。
HPeV和EV是不明原因发热的重要致病病毒。这些病毒感染存在特征性临床表现，但需要进一步研究积累更多病例，以全面了解这些病毒感染情况。
