Article in Japanese

Human parechovirus type 3 infection complicated by high serum CPK value in early infancy

Saho HONJO¹⁾, Yoshiyuki SAKAI¹⁾, Minami YODA¹⁾, Hiroyuki TSUTSUMI²⁾

This study reported a 2-month-old boy with high serum creatine phosphokinase (CPK) levels associated with HPeV-3 infection. He was admitted to hospital presenting fever and poor sucking. His CPK level was elevated at 909 IU/l, but no abnormality was found in other blood analyses or his cerebrospinal fluid or urine. Various rapid antigen tests were negative, thus no possibility of bacterial infection was considered. The patient's fever decreased on the fourth hospital day, and he was discharged on the seventh day. The serum CPK value decreased to within the natural level after several days. The virus was isolated from cerebrospinal fluid with tissue culture, and classified as HPeV-3 by genomic analysis.
In 1999, HPeV-3 was first isolated in Japan from a stool specimen of a 1-year-old infant with transient paralysis. A relationship between myalgia and HPeV-3 infection has been reported in many adult cases, but in only 5 child cases. Evaluation of muscle pain and weakness in early infants is difficult, due to its dependence on only clinical symptoms. It was considered that myalgia and myositis caused high serum CPK. The possibility of HPeV-3 infection-associated myalgia and myositis needs to be considered as differential diagnosis when early infants develop an acute febrile disease and high serum CPK value.

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1) Department of Pediatrics, Hakodate Municipal Hospital
2) Department of Pediatrics, Sapporo Medical University School of Medicine

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Received	June 30, 2016
Accepted	February 2, 2017

29 (1)：55─60,2017