Table 2 Reports included and the major finding
From: Human parechovirus meningitis in children: state of the art
Domains | Reference | Type of Publication | Country (Continent) | Highlighted |
|---|---|---|---|---|
Clinical Presentation Laboratory Imaging Outcome | Ancora G, 2020 [1] | Case Report | Italy (Europe) | Six neonates presented with fever and poor feeding, rash in 3 cases, seizures in one. Blood analyses revealed lymphopenia, normal or mildly elevated CRP, no pleocytosis. Head ultrasound and brain MRI were abnormal only in one case. The median hospitalisation was 11 days (range 7–26). At 2 years follow up just one developed epileptic encephalopathy, vision and psychomotor development impairment |
Epidemiology | Naccache SN, 2018 [5] | Retrospective study | USA (America) | In the period study, out of 251 patients, 0.4% of CSF was positive for HPeV |
Epidemiology | Abedi GR, 2019 [6] | Retrospective multicentre study | USA (America) | In the period study, 3.4% of children under the age of 1 year had CSF positive for HPeV |
Epidemiology | Lee BR, 2020 [7] | Retrospective cohort study | USA (America) | In the period study, out of 1926 specimens of CSF in children less than 6 months of age, 8.9% were positive for HPeV |
Epidemiology Clinical Presentation Laboratory | Tomatis Souverbielle C, 2021 [8] | Retrospective study | USA (America) | In the period study, out of 1475 infants younger than 60 days, 130 were HPeV positive. Infections mainly occurred in summer. Out of them, 96% had fever, 75% fussiness, and 29% a rash. In CSF, protein and glucose levels were within the normal ranges; 77% had no CSF pleocytosis. HPeV type 3 was the only one detected in CSF |
Epidemiology Clinical Presentation | Sasidharan A, 2021 [9] | Single-site study | USA (America) | In the period study, 7% (271/4,016) CSF were positive for HPeV. 95% was HPeV type 3. Most infections occurred during summer. Most patients were males (169/271; 62%) with a median age of 27.2 days, only six (2%) were 4-6-month-old |
Epidemiology Clinical Presentation Imaging Therapy | Hardeep Singh S, 2023 [10] | Retrospective study | USA (America) | In the period study, out of 14 patients with HPeV on CSF, 43% were infected in summer-fall and 57% in spring. Median age was 21 days, 57% were male. Symptoms were fever and fussiness (100%), poor oral intake (50%), seizures (7%). One out of 4 patients had abnormal MRI findings. Anti-epileptics medicines, corticosteroids and intravenous immunoglobulin were used in 2 patients with seizures. All the others received supportive care. |
Epidemiology | Black S, 2019 [11] | Original research | UK (Europe) | In the period study, 32 CSF specimens were HPeV positive, all genotype 3, with an outbreak in summer 2016. Patients had 25.5–61 days, 59.4% were male, 100% had fever, 68.8% poor feeding, 25% rash, 3.1% seizures, 37.5% respiratory symptoms (coryza, cough, wheeze) |
Epidemiology Clinical Presentation Laoratory Imaging Outcome | Antolin LF, 2018 [12] | Original research | UK (Europe) | HPeV infection’s highest peak was in summer. 43% were neonates; 42% were less than 90 days. Symptoms were: fever (92%) irritability (63%), reduced feeding (49%), rash (25%), lethargy (23%), diarrhoea (15%). 7% of infants had anaemia, 14% lymphopenia, 4% neutropenia and 4% thrombocytopenia, 75% low CRP level. On CSF, WCc was higher than 20 cell/mcL in 8% of neonates and higher than 5 cell/mcL in 7% of infants. Head ultrasound was normal in 10 infants; MRI scans were normal in 5/7, compatible with encephalitis in 1/7 and with brain oedema in 1/7. Median hospitalisation was 3 days (range 2–11) After discharge, 5 infants had ongoing seizures and 1 neurological impairment |
Epidemiology | Cosgun Y, 2020 [13] | Retrospective study | Turkey (Europe) | In the period study, out of 5255 CSF samples, two were HPeV positive |
Epidemiology Clinical Presentation Laboratory | Chakrabarti P, 2018 [14] | Retrospective study | UK (Europe) | In the period study, out of 140 CSF samples, 10% tested positive for HPeV. Out of them, 85% were less than 2 months of age, 100% had fever, 42% irritability, 14% lethargy, 42% a maculo-papular rash. No CSF sample showed pleocytosis and just 21.4% had increased CSF protein levels. HPeV meningitis had lower CSF WCc than EV meningitis |
Epidemiology | Sirin MC, 2018 [15] | Retrospective cross-sectional study | Turkey (Europe) | In the period study, out of 59 CSF specimens, 1.7% resulted HPeV positive |
Epidemiology | Bal A, 2022 [16] | Multicentre cross-sectional retrospective study | Turkey (Europe) | In the period study, out of 179 CSF samples, two were HPeV positive |
Epidemiology Clinical Presentation Laboratory | De Jong EP, 2018 [17] | Prospective observational cohort study study | The Netherlands (Europe) | In the period study, out of 353 samples of infants aged less than 90 days, 39 were HPeV positive; type 3 was the only genotype found. Out of them, 46% were neonates, 62% were male. 100% had fever and 20% a rash. Compared to EV, HPeV meningitis have lower infection indices and lower rate of CSF pleocytosis |
Epidemiology Laboratory | Eichinger A, 2019 [18] | Retrospective study | Germany (Europe) | In the period study, out of 187 CSF samples, two were HPeV positive, occurring in May and September. CSF WCc had a mean value of 10 +/- 4 cell/mcL. CSF Protein level was normal |
Epidemiology | Elling R, 2019 [19] | Original research | Germany (Europe) | In the period study, out of 11 CSF of 25 HPeV infected patients, 8 tested positive for HPeV type 3. Most of the infections occurred in summer |
Epidemiology | Posnakoglou L, 2020 [20] | Prospective cohort study | Greece (Europe) | In the period study, out of 142 CSF samples, four were HPeV positive (2.8%) |
Epidemiology Clinical Presentation Laboratory Therapy Outcome | Posnakoglou L, 2021 [21] | Prospective cohort study | Greece (Europe) | In the period study, out of 330 CSF specimens, 6 were HPeV positive (1.8%); type 3 was the only genotype. Patients were all under 3 months of age, 83% males. 100% presented with fever, 50% rash, and 16% seizures. No pleocytosis and normal levels of protein and glucose were found in CSF. All received antibiotics and one neonate also had intravenous immunoglobulin. Hospitalisation was 7.5 days long (IQR: 5.3–10.3) |
Epidemiology | Vincent JJ, 2020 [22] | Original research | France (Europe) | In the period study, out of 309 CSF samples, 12 were HPeV positive |
Epidemiology Clinical Presentation Laboratory | Marchand S, 2021 [23] | Retrospective study | France (Europe) | In the period study, out of 1373 CSF specimens, 34 tested positive for HPeV. No seasonality was observed. 97% were under 3 months of age, 100% presented with fever, 13% had an erythematous and maculopapular rash, 23% had diarrhoea. Pleocytosis was observed in 11% of cases, lower than in case of EV meningitis |
Epidemiology | Schnuriger A, 2022 [24] | Original research | France (Europe) | In the period study, out of 1,744 CSF samples, 11 cases of HPeV infection were identified, and they all occurred in neonates |
Epidemiology Clinical Presentation Imaging Outcome | Bucci S, 2022 [25] | Original research | Italy (Europe) | In the period study, 3 out of 15 CSF samples of newborns with viral meningitis were HPeV positive. All presented with fever. Head ultrasound was normal in all patients, MRI in 1. At 1 year follow up, 29 out of 30 patients had no sequela. Just one child had a mild delay in fine and gross motor skills and in receptive language |
Epidemiology Clinical Presentation Laboratory Imaging Outcome | Stephens C, 2021 [26] | Retrospective study | Ireland (Europe) | In the period study, there were 23 cases of CSF HPeV positive, all younger 2 months of age; 90% were serotype 3. No seasonality was found. Out of them, 90% was febrile, 40% irritable, 20% lethargic, 10% had seizures. None had CSF pleocytosis. Just 25% showed frontoparietal white matter changes at MRI. At 3 years follow up, 60% of patients had a normal development |
Epidemiology Clinical Presentation Laboratory | Sano K, 2018 [27] | Prospective study | Japan (Asia) | In the period study, over 56 febrile infants, 2 tested positive for HPeV on CSF. HPeV infections had a summer peak. Fever was the symptom of presentation. WBC count, platelets values and CSF pleocytosis rate was lower than in EV |
Epidemiology Clinical Presentation Imaging Outcome | Abe Y, 2021 [28] | Retrospective study | Japan (Asia) | In the period study, 34 out of 240 infants with HPeV infection had acute CNS involvement. 87% were younger than 2 months of age, 87% presented with fever and 65.2% with seizures. 57.1% presented with lesions on 15 months follow-up MRI. Half patients with abnormalities at MRI follow-up had neurological sequelae. Patients with normal MRI follow-up had no neurological sequelae |
Epidemiology | Izumita R, 2019 [29] | Prospective study | Japan (Asia) | In the period study, over 54 febrile neonates and young infants, HPeV was detected in serum and/or CSF of 14 patients |
Epidemiology | Suziki Y, 2021 [30] | Prospective study | Japan (Asia) | In the period study, 60/216 infants were found to have an HPeV infection on serum or CSF. HPeV type 3 was detected in 93% of cases, HPeV type 4 in 5% and 2% of untyped virus |
Epidemiology Laboratory | Park SE, 2019 [31] | Prospective cohort study | Korea (Asia) | In the period study, out of 90 children less than 1 year) of age with fever and sepsis-like signs, 10 had HPeV meningitis. In the CSF there was a significantly higher level of IL-2, IL-4, IL-7 and IL-13, than in controls |
Epidemiology Clinical Presentation Laboratory | Park SE, 2021 [32] | Retrospective cohort study | Korea (Asia) | In the period study, HPeV was identified in 10 CSF samples out of 110. 70% aged younger than 2 months, 20% were male. All presented with fever, 20% with seizures. Compared to other viral meningitis, CSF samples had the lowest value of white cell count |
Epidemiology Clinical Presentation Laboratory | Rhie S, 2020 [33] | Retrospective study | Korea (Asia) | In the study period, 14 out of 161 CSF samples were HPeV-positive. All patients were younger than 3 months of age, 42.9% were male. All had fever. Compared to EV meningitis, patients had lower WCB count and lower rate of CSF pleocytosis |
Epidemiology | Nam EJ, 2021 [34] | Retrospective study | Korea (Asia) | In the study period, over 2230 CSF samples, 10 were positive for HPeV. They all aged less than 3 months. HPeV was found only in summer |
Epidemiology | Chang JT, 2018 [35] | Retrospective study | Taiwan (Asia) | In the study period, 1 out of 112 children aged less than 10 years and positive for HPeV was affected by HPeV meningitis |
Epidemiology Laboratory | Nassrallah B, 2021 [36] | Retrospective study | Israel (Asia) | In the study period, 5 out of 80 febrile infants aged less than 3 months had CSF positive for HPeV. Pleocytosis was absent in all |
Epidemiology | Mathew S, 2021 [37] | Retrospective study | Qatar (Asia) | In the study period, HPeV was isolated in 26 out 30 children aged less than 9 years |
Epidemiology Laboratory | O’Brien MP, 2018 [38] | Retrospective and prospective cohort study | Australia (Oceania) | In the study period, 8 out 65 children aged 0–16 years with meningitis were HPeV positive. Five cases were aged less than 3 months. No pleocytosis was found |
Epidemiology | Berkhout A, 2023 [39] | Retrospective study | Australia (Oceania) | In 2o19, 5/93 infants’ CSF samples tested HPeV positive; in 2021 no HPeV was detected in CSF samples |
Epidemiology | Chamings A, 2019, [40] | Original Reserach | Australia (Oceania) | In the period study, 26 out of 33 infants affected by HPeV had meningitis; the only genotype was HPeV3 |
Epidemiology Clinical Presentation Laboratory | Chamings A, 2019 [41] | Retrospective study | Australia (Oceania) | 6 cases of HPeV meningitis were reported in children aged 14–68 days, all caused by HPeV type 5. Symptoms were irritability, fever, tachycardia, erythematous rash, poor feeding, irritability, dyspnoea. Blood analysis on 2 cases showed respectively WBCc of 5700 and 6500/mmc, CRP not elevated in the first case and mildly elevated in the second. CSF protein values were respectively normal and mildly elevated |
Epidemiology | Abdelrahim NA, 2022 [42] | Cross-sectional study | Sudan (Africa) | Between December and August 2010, 0/503, febrile children tested positive for HPeV in CSF |
Epidemiology | Fourgeaud J, 2022 [43] | Retrospective study | Comoros (Africa) | Between March and June 2019 only 1/122 CSF tested positive for HPeV, collected from a 30-days-aged infant in early June |
Clinical Presentation Laboratory Outcome | Garrido R, 2022 [44] | Case Report | Portugal (Europe) | An 11-day-old infant with fever, irritability, and poor feeding, CSF pleocytosis and increased protein level recovered well. At 18 months follow up, she was in health |
Clinical Presentation Laboratory Imaging Therapy | Fox B, 2022 [45] | Case Report | Argentina (America) | In the reported three cases, symptoms were fever, decreased oral intake, irritability, rash, seizures, bradycardia, desaturation, abdominal tenderness. CSF was clear and colourless, pleocytosis absent. Mild proteinorraquia was reported in one case. In just one case head ultrasound showed subcortical white matter hypoechogenicity of both cerebral hemispheres, corpus callosum, and both temporal lobes. Intravenous antibiotics and antiepileptic medicines were administered. |
Clinical Presentation | Alhazmi A, 2020 [46] | Case Report | France (Europe) | One-month-old baby girl with high fever, irritability, vomiting, and diarrhoea for 36Â h |
Clinical Presentation | Chowdhury SR, 2020 [47] | Case Report | Singapore (Asia) | 3-month-old infant with fever, tachycardia, acral swelling and maculo-papular rash |
Clinical Presentation Laboratory Imaging Outcome | Berk MC, 2018 [48] | Case Report | The Netherlands (Europe) | A male premature neonate born at 32 weeks and 6 days gestational age presented with sepsis-like symptoms, elevated serum CRP, mild pleocytosis, low level of proteins and normal values of glucose in CSF. Head ultrasounds was normal, MRI showed bifrontal periventricular abnormalities of the white matter. He was discharged at 37 weeks and 6 days of life. At 5 years follow up the patient presented with cerebral palsy, vision, and psychomotor development impairment |
Clinical Presentation Imaging Outcome | Piralla A, 2019 [49] | Case Report | Italy (Europe) | A 15-day-old boy with high fever, poor feeding, inconsolability, tachycardia, and mild axial hypotonia had a negative head ultrasound and a normal brain MRI at a 2 months follow up. Hospitalisation lasted 7 days |
Clinical Presentation Imaging Therapy | Yehia R, 2023 [50] | Case Report | USA (America) | Two neonates presented with fever, fussiness, seizures, apnoea, and cyanosis. They had normal head ultrasound and head CT. Patient 1 had normal brain MRI findings. Patient 2 showed restricted diffusion throughout the bilateral white matter and leptomeningeal enhancement on MRI. Both patients received intravenous immunoglobulin and corticosteroids. |
Clinical Presentation Laboratory | Kirkley MJ, 2019 [51] | Case Report | USA (America) | A 15-day-old infant with fever, fussiness, irritability, poor feeding, grunting respirations and distended abdomen had normal WBC count, in CSF normal WBC count, glucose and normal proteins |
Clinical Presentation Laboratory | Kanagaratnam M, 2019 [52] | Case Report | UK (Europe) | 7 neonates presented with fever and severe irritability, 60% with rash, and 30% with diarrhoea. Blood WBC count was normal, and CRP was low in 90% of cases. CSF tests showed normal WBC count, protein, and glucose levels |
Clinical Presentation Laboratory | Urooj F, 2019 [53] | Case Report | UK (Europe) | 4 patients aged 1–10 weeks, 50% female, had high fever, sepsis-like-symptoms, and irritability, 50% a maculo-papular rash. CRP serum values were normal or slightly elevated. CSF samples had a normal WBC count |
Clinical Presentation | Lee D, 2018 [54] | Case Report | Singapore (Asia) | 2-month-old girl with fever, irritability, and maculopapular exanthema. On day three, she developed nontender palmoplantar erythema |
Clinical Presentation Laboratory | Masanori T, 2022 [55] | Case Report | Japan (Asia) | A 2-month-old girl with fever, poor general condition, severe abdominal distention, rash and acral foot reddening showed low values of WBC count and negative CRP. CSF examination showed normal results |
Clinical Presentation Laboratory Imaging Therapy Outcome | Tokmak DN, 2021 [56] | Case Report | Turkey (Europe) | A 38-day-old infant with sepsis-like condition, fever and rash had normal WBC count on CSF and blood, low haemoglobin value, normal biochemical parameters, and CRP mildly elevated. Head ultrasound was normal. He received intravenous antibiotics and acyclovir. hospitalisation was 6 days long |
Clinical Presentation Laboratory Imaging Therapy Outcome | Tokak S, 2021 [57] | Case Report | Turkey (Europe) | A 43-day-old girl with HPeV meningitis presenting with fever, sucking weakness and petechial rashes. She had slightly elevated serum CRP. CSF analysis showed a clear fluid, lack of pleocytosis and low levels of glucose. Antibiotic therapy was administered. Brain MRI was normal. Hospitalisation lasted 8 days |
Clinical Presentation Imaging | Tierradentro-GarcÃa LO, 2022 [58] | Case Report | USA (America) | 15-day-old boy with confluent erythematous rash on trunk, poor feeding, irritability, fever, seizures of the right arm and rightward eye deviation; 11-day-old boy with fever, irritability, apnoea episodes, and right-sided clonic seizure; 17 years-old girl, in immunosuppressive therapy, with fever and left-side weakness, unsteady gait, headache. Head ultrasonography showed increased echogenicity of the periventricular WM. Brain MRI showed restriction of diffusion in WM matter, with a frontoparietal predominance |
Clinical Presentation Outcome | van Hinsbergh T, 2022 [59] | Prospective multicentre study | The Netherlands (Europe) | The median age of onset is 29 days; 91% are males. In the 5-year-follow-up, patients had gross motor impairment |
Clinical Presentation Outcome | van Hinsbergh TMT, 2019 [60] | Prospective multicentre study | The Netherlands (Europe) | 9 patients with a median age of 31 days, 89% male had fever (100%), irritability (77.8%), poor feeding (55.6%), lethargy (22.2%), rash (33.3%) At 6 months follow up, 6 had a gross-motor function delay |
Clinical Presentation Laboratory | Tan JHY, 2022 [61] | Retrospective study | Singapore (Asia) | 71 children younger than one year, presented with fever, and 42% with poor feeding. Out of them, 2.8% presented with CSF pleocytosis, median CSF level of proteins of 0.43Â g/L and median value of glucose 3.2 mmol/L |
Clinical Presentation Laboratory Imaging Therapy Outcome | Linhares MI, 2021 [62] | Original research | Portugal (Europe) | 7 neonates, of which six males, presented with fever and irritability, two with acral involvement rash, two with gastrointestinal symptoms, and one with seizures. In CSF no pleocytosis, protein and glucose normal values were found. Head ultrasound was normal. Empirical intravenous antibiotics were started in six infants, until negative culture results were obtained. Hospitalisation had a mean of 5.6 days (3–11 days). Outcome was favourable. |
Clinical Presentation Laboratory | Kielar M, 2019 [63] | Retrospective study | Poland (Europe) | Neonatal HPeV CNS infections all presented with fever and irritability. Analysis revealed leukopenia, low inflammatory index. On CSF, low glucose values were found in 3 patients and increased cell count was found in 7 patients |
Clinical Presentation | Samarasekara H, 2020 [64] | Original research | Australia (Oceania) | 5 cases, two-six weeks of age. All with fever and sepsis-like symptoms; four were irritable and one presented desaturation and tachypnoea |
Clinical Presentation Imaging Outcome | Silcock RA, 2022 [65] | Prospective cohort study | Australia (Oceania) | Median age was 27 days, 62.5% were male, 7.8% had seizures, 32.5% abnormal findings on brain MRI (bilateral white matter signal changes and periventricular restricted diffusion patterns). In the second year of life, 63% (29/46) children showed developmental delay, which ameliorated by the third year of life (30%). Communication was the most common domain of concern |
Clinical Presentation Imaging Outcome | Joseph L, 2019 [66] | Retrospective study | Australia (Oceania) | Out of 77 patients, 87.5% were under 3 months, (37.2% neonates) and 56.4% male. 9.7% of patients had seizures. 15 out of 20 children had abnormal MRI findings (restricted diffusion in deep white matter); at follow-up 11 (14%) had neurodevelopmental delay |
Clinical Presentation Laboratory Imaging | McKenna R, 2019 [67] | Retrospective multicentre study | Australia (Oceania) | Patients admitted to ICU were all younger than 3 months, 93% had irritability, 57% apnoea, and 40% seizures. Lymphopenia was found in most of the cases. CRP values were low or mildly elevated. 27% of patients had hyponatremia and 70% had increased transaminase values. Pleocytosis was absent, CSF protein level was normal and glucose values ranged from 2.3 to 6.7 mmol/L. 78% of patients with white matter alterations on MRI developed severe diseases |
Clinical Presentation Imaging Therapy | Midgley CM, 2018 [68] | Retrospective study | USA (America) | 35 neonates presented with 91% fever, 2% hypothermia, 77% tachycardia, 77% poor feeding, 74% irritability, 26% rash, 20% seizures and 9% breathing difficulties. Brain MRI was performed in 3 infants who presented seizures, showing white matter abnormalities, EEG severe encephalopathy and multifocal epileptiform discharges in 2 cases. Acyclovir and anticonvulsant medication were administered in patients with seizures. |
Clinical Presentation Laboratory Therapy | Kadambari S, 2019 [69] | Prospective study | UK (Europe) | Out of 35 patients, 80% had fever, 66% poor feeding, 66% irritability, 51% lethargy, 29% rash. CSF WBC count was less than 20/mm3, serum CRP was low in 67% of cases.Empiric intravenous antibiotics were administered. 46% of patients received acyclovir. One patient received intravenous immunoglobulin. |
Clinical Presentation Laboratory Outcome | Roh DE, 2020 [70] | Retrospective study | Korea (Asia) | 11 patients, median age of 41 days, presented with fever (100%), poor feeding (81.8%), irritability (63.6%), tachycardia (63.6%), tachypnoea (36.4%), apnoea (18.2%), seizures (9.1%). Blood tests showed a mean WBCc value of 5622/mmc. CRP e procalcitonin were low. Hyponatremia and mild transaminasemia were reported. Pleocytosis was absent. Protein and glucose values in CSF were normal. Hospitalisation was of 7.1 ± 3.6 days |
Clinical Presentation Imaging | Hilbig, A, 2022 [71] | Case Report | Australia (Oceania) | Neonate with congenital HPeV meningitis was born in poor condition and with petechiae. MRI on day 2 of life demonstrated diffuse subcortical white matter abnormality |
Clinical Presentation Laboratory Imaging | Lim SMJ, 2022 [72] | Case Report | Japan (Asia) | At birth the neonate with congenital HPeV3 meningoencephalitis was irritable and at 9Â h of age, febrile with repeated episodes of desaturation, bradycardia, and abnormal limb movements. CSF showed no pleocytosis, normal levels of glucose and slightly elevated levels of proteins. Brain MRI performed on day 2 of life demonstrated white matter inflammatory changes; EEG was compatible with seizure activity |
Clinical Presentation Laboratory Imaging Therapy Outcome | Salavati S, 2020 [73] | Case Report | The Netherlands (Europe) | A preterm neonate with congenital HPeV meningoencephalitis, after birth became bradycardic, pale, hypotonic. He was intubated and ventilated for 5 days. Pleocytosis was found in CSF. MRI demonstrated bilateral ischemic injury, restricted diffusion in white matter, corpus callosum, corticospinal tract, pulvinar and optic radiation. EEG showed subclinical seizures. Antibiotic and antiepileptic therapy was administered. At 2 years follow up the patient presented cerebral visual impairment, cognitive, language and internalising behaviour problems |
Laboratory Outcome | Izumita R, 2019 [74] | Original Research | Japan (Asia) | Pleocytosis was absent in all 16 CSF samples. 1 out of 16 patients had a severe neuro-psychomotor retardation at a 3 year follow up |
Laboratory | Sugiura K, 2020 [75] | Case Report | Japan (Asia) | Higher levels of IL-6, IL-17 and TNF alpha were found in the serum of patients affected by HPeV meningitis compared with controls |
Laboratory | Habuka R, 2020 [76] | Original Research | Japan (Asia) | Higher serum level of proinflammatory cytokine/chemokine was present in HPeV infected patients than in Enterovirus infected patient |
Imaging | Sarma A, 2019 [77] | Retrospective case series | USA (America) | Head ultrasound had normal findings in 2/6 patients. All cases had brain MRI exhibiting diffuse and multifocal subcortical white matter involvement |
Imaging | Lane LM, 2021 [78] | Case Report | Ireland (Europe) | An infant boy with HPeV meningoencephalitis had normal head ultrasound. Brain MRI showed extensive diffusion abnormalities in the deep white matter, corpus callosum, deep grey nuclei and midbrain. EEG showed multiregional seizure onset |
Therapy | Rhoden E, 2020 [79] | Original research | USA (America) | Posaconazole inhibits HPeV-A3 infection by directly targeting the capsid and interfering with virus-cell interactions. |
Outcome | De Ceano-Vivas M, 2021 [80] | Original research | Spain (Europe) | At a 18 months follow up, 3 out of 15 (20%) patients presented developmental concern |
Outcome | De Crom SC, 2021 [81] | Multicenter prospective cohort study | the Netherlands (Europe) | At 24 months follow-up, 3 children with previous HPeV infection, including a case of meningitis, had impaired motor development |
Outcome | Martin del Valle F, 2019 [82] | Original Research | Spain (Europe) | At 2 years follow up 1 out of 15 patients presented with a gross motor dysfunction |
Outcome | Britton PN, 2018 [83] | Cohort study | Australia (Oceania) | At 12 months following hospitalised HPeV infection, 5% of infants showed severe neurological sequelae, 23% moderate, 11% mild and 61% had a normal neurodevelopment. Neurological impairment mainly interested the gross motor domain |
Outcome | Britton PN, 2020 [84] | Cohort study | Australia (Oceania) | At 3 years following hospitalised HPeV infection, all children showed age-appropriate development on BSID-III. The lowest scores were in the gross motor domain, but still in the normality range |