Weichelt Bryan, Hooper Elisabeth, Chow Brian
Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI, USA.
Pediatric Intensive Care Unit, Marshfield Clinic Health System, Marshfield, WI, USA.
IDCases. 2019 Jan 24;15:e00494. doi: 10.1016/j.idcr.2019.e00494. eCollection 2019.
Human parechovirus (HPeV) infections appear common across age groups, and transmission is likely fecal-oral and through respiratory secretions. Cyclical and seasonal patterns have been described; however, HPeV has likely been previously underdiagnosed due to lack of commercially available diagnostic testing.
We present identical triplets contracting HPeV Type 3.
The clinical presentation, similar to echoviruses, is broad and includes asymptomatic shedding, severe pulmonary and neurologic disease, and disseminated intravascular coagulation. Neonates and young infants are particularly susceptible. In neonates, distinctive MRI brain findings have been described that, when combined with clinical presentation, suggest HPeV. Infection clusters have been described, and neonates with older siblings may be a risk factor.
This case suggests that HPeV has been under-recognized in the United States, and HPeV Type 3 prevalence is likely underestimated. The case highlights variation in presentation, including lack of fever and rash, which were previously documented as common HPeV symptoms.
人细小病毒（HPeV）感染在各年龄组中似乎都很常见，传播途径可能是粪口传播和通过呼吸道分泌物传播。已有周期性和季节性模式的描述；然而，由于缺乏商业化的诊断检测方法，HPeV此前可能一直未得到充分诊断。
我们报告了三胞胎感染3型HPeV的病例。
其临床表现与埃可病毒相似，范围广泛，包括无症状排毒、严重的肺部和神经系统疾病以及弥散性血管内凝血。新生儿和幼儿尤其易感。在新生儿中，已描述了独特的脑部MRI表现，结合临床表现提示为HPeV感染。已有感染聚集性病例的报道，家中有年长同胞的新生儿可能是一个危险因素。
该病例表明HPeV在美国未得到充分认识，3型HPeV的流行率可能被低估。该病例突出了临床表现的差异，包括缺乏发热和皮疹，而这些症状此前被记录为常见的HPeV症状。
