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Japanese

Title 新生児期発症ヒトパレコウイルス脳炎の軽症例
Subtitle 症例報告
Authors 荒巻良子1, 福岡正隆1, 汐田航平2, 石岡梨紗子1, 松原康平1, 山田直紀1, 堀田貴大2, 奥野英雄2, 温井めぐみ1, 井上岳司1, 九鬼一郎1, 西本静香3, 茶山公祐3, 天羽清子2, 岡崎伸1
Authors (kana)
Organization 1大阪市立総合医療センター小児脳神経・言語療法内科, 2同 小児救急・感染症内科, 3市立豊中病院小児科
Journal 脳と発達
Volume 57
Number 5
Page 377-381
Year/Month 2025 / 9
Article 報告
Publisher 日本小児神経学会
Abstract 「要旨」ヒトパレコウイルス(human parechovirus;HPeV)感染症では, 新生児・乳児期に敗血症様症状で発症し, 多臓器障害, 中枢神経症状などをきたし重症化する症例が多く報告されており, 頭部MRIで大脳白質を中心とした信号異常を認め, 急性脳炎と診断される症例も散見される. 今回我々は新生児期の発熱で医療機関を受診し, 髄液検査上, 細胞数の上昇はなく, FilmArray(R)髄膜炎・脳炎パネル(以下, FilmArray(R))でHPeVが検出された症例を2例経験した. うち1例では後にreal-time PCRで髄液検体からHPeV-3を検出した. 両症例とも, 髄液ネオプテリンの上昇を認め, 頭部MRIで大脳白質や脳梁に微細な病変がみられたが, けいれんなどの発作症状や意識障害を認めず, 神経学的異常所見も認めなかった. 退院時点でも後遺障害を認めず, 軽症型HPeV脳炎であったと考えた. 今回経験したFilmArray(R)で診断された軽症例を含むHPeV脳炎の疫学調査と, そのような症例の長期的発達予後を検討する必要があると考える.
Practice 臨床医学:内科系
Keywords ヒトパレコウイルス, 急性脳炎, FilmArray(R)髄膜炎・脳炎パネル, ネオプテリン, フェリチン, human parechovirus, acute encephalitis, FilmArray(R) Meningitis/Encephalitis (ME) Panel, neopterin, ferritin

English

Title Mild-form human parechovirus encephalitis in the neonatal period
Subtitle Case Reports
Authors Ryoko Aramaki1, Masataka Fukuoka1, Kohei Shiota2, Risako Ishioka1, Kohei Matsubara1, Naoki Yamada1, Takahiro Horita2, Hideo Okuno2, Megumi Nukui1, Takeshi Inoue1, Ichiro Kuki1, Shizuka Nishimoto3, Kosuke Chayama3, Kiyoko Amo2, Shin Okazaki1
Authors (kana)
Organization 1Department of Pediatric Neurology and Neurolinguistics, 2Department of Pediatric Emergency Medicine and Infectious Diseases, Osaka City General Hospital, 3Department of Pediatrics, Toyonaka Municipal Hospital
Journal NO TO HATTATSU (Official Journal of The Japanese Society of Child Neurology)
Volume 57
Number 5
Page 377-381
Year/Month 2025 / 9
Article Report
Publisher The Japanese Society of Child Neurology
Abstract Many cases of human parechovirus (HPeV) infection have been reported to present with sepsis-like symptoms in neonates and infants and to progress to multiple organ damage and central nervous system symptoms, leading to severe illness. There are a cetrain number of cases in which brain magnetic resonance imaging (MRI) shows abnormal lesions mainly in the white matter, leading to the diagnosis of acute encephalitis. In the present study, we detail our experience with two cases of HPeV detected using Film Array(R) Meningitis/Encephalitis (ME) Panel, in whom cerebrospinal fluid (CSF) analysis revealed no elevation in cell count or protein levels, visiting a medical facility for a fever in the neonatal period. In one case, HPeV type 3 was later proven in cerebrospinal fluid (CSF) by real-time polymerase chain reaction. In both cases, neopterin in CSF was elevated and brain MRI showed subtle lesions in the cerebral white matter and corpus callosum ; however, there were no central nervous system symptoms such as convulsions or disturbance of consciousness, and no neurological abnormalities were evident on physical examination. Both patients had no obvious permanent disability at the time of discharge from the hospital, and we considered these cases to be a mild form of HPeV encephalitis. It is considered necessary to study the epidemiology of HPeV encephalitis including the mild-form cases diagnosed by FilmArray, and the long-term developmental prognosis of these cases.
Practice Clinical internal medicine
Keywords human parechovirus, acute encephalitis, FilmArray(R) Meningitis/Encephalitis (ME) Panel, neopterin, ferritin
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