The Journal of Pediatric Infectious Diseases and lmmunology Online Journal

Abstract

The Journal of Pediatric Infectious Diseases and Immunology > Vol.36 No.3 contents > Abstract

Article in Japanese

Clinical utility of FilmArray Meningitis/Encephalitis Panel in an epidemic of human parechovirus central nervous system infection

Shoichiro Wada1), Masashi Kasai2), Yuichiro Matsui3), Yoshihiko Tanimoto4), Minori Oyama4), Ai Mori4), Yuta Aizawa5), Yoshimichi Yamaguchi1), Keigo Hamahata3), Kousaku Matsubara1)

Human parechovirus (HPeV) is a pathogen that causes central nervous system infection in infants, but its diagnosis has been difficult because of the paucity of pleocytosis on cerebrospinal fluid (CSF) examination. Recently, molecular panels have become available for the simultaneous diagnosis of multiple microorganisms using multiplex polymerase chain reaction. In this study, we evaluated the clinical usefulness of the FilmArray Meningitis/Encephalitis Panel (FA-ME) in 16 cases of HPeV meningitis/encephalitis diagnosed between July and September 2023 in institutes in Kobe and described the clinical characteristics of patients with HPeV meningitis/encephalitis. The median age of onset was 32 days (all children were less than 3 months old), and all presented with sepsis characterized by high fever and tachycardia. All children had normal CSF cell counts, protein and glucose levels, and no elevation of serum C-reactive protein. In all cases, HPeV was detected by FA-ME within the third day of hospitalization, allowing for rapid and accurate diagnosis. Information about the detection of the first case was shared through a local mailing list, resulting in early diagnosis of subsequent cases. The 16 cases of HPeV infection were recognized as an epidemic in southern Hyogo Prefecture, based on the geographical and temporal proximity of the cases, subsequent virological testing confirming that all were HPeV type 3, and the high homology of the gene sequences. These results indicate that FA-ME is useful for rapid and accurate diagnosis of HPeV meningoencephalitis in early infancy and contributes to efficient sharing of the regional epidemics.


1)Department of Pediatrics, Kobe City Nishi-Kobe Medical Center
2)Division of Infectious Diseases, Department of Pediatrics, Hyogo Prefectural Kobe Children’s Hospital
3)Department of Pediatrics, Kobe City Medical Center General Hospital
4)Department of Infectious Diseases, Kobe Institute of Health
5)Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences

Key words human parechovirus, aseptic meningitis, encephalitis, multiplex polymerase chain reaction-based testing, epidemic
Received May 3, 2024
Accepted July 9, 2024

36 (3):233─243,2024

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