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Here’s a bullet-point summary of "Clinical Manifestations and Viral Codetections in Infants With Parechovirus A":

• Background:

  • Parechovirus A (PeV-A) is an important but often overlooked cause of acute febrile illness, respiratory infections (RTI), and CNS infections in infants.

  • PeV-A3 specifically is linked to sepsis-like disease (SLD) in neonates.

• Methods:

  • Observational study at St. Olavs Hospital (2006–2017).

  • Infants <6 months with fever and/or respiratory symptoms underwent nasopharyngeal aspirate testing for PeV-A and other viruses.

  • Lumbar puncture done based on clinical indications.

• Results:

  • 28/1001 infants (2.8%) tested positive for PeV-A.

  • 16 infants had sepsis-like disease (SLD):

    • Median age: 1.1 months.

    • Common features: Fever (100%), Irritability (94%), Rash/Skin mottling (81%), Poor feeding (94%), Abdominal distension (56%).

    • 63% showed signs of compromised circulation.

    • 94% had PeV-A3.

    • Codetections were rare (only rhinovirus or parainfluenza virus in a few cases).

    • Low CRP and normal WBC counts typical.

    • One case of encephalitis with MRI-confirmed white matter injury.

  • 12 infants had RTI or fever of unknown origin (FUO):

    • Median age: older (median 4.9 months).

    • More respiratory symptoms.

    • Various PeV-A genotypes (PeV-A1, PeV-A5, PeV-A6).

    • Frequent viral codetections (mostly rhinovirus, RSV).

• Conclusions:

  • PeV-A3 should be considered in young infants (<3 months) with sepsis-like illness, even with low inflammatory markers.

  • Other PeV-A genotypes are more common in older infants (3–6 months) with respiratory symptoms and viral coinfections.

  • Clinicians should remember PeV-A in the differential diagnosis of febrile infants, especially when bacterial infection workup is negative.

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