アブストラクト
Japanese
| Title | 日齢7に発症したヒトパレコウイルス3型脳炎の新生児例 |
|---|---|
| Subtitle | 原著 |
| Authors | 岡村卓実, 桐村章大, 安原肇, 恵美須礼子, 扇谷綾子, 箕輪秀樹 |
| Authors (kana) | |
| Organization | 奈良県総合医療センター 新生児集中治療部 |
| Journal | 日本新生児成育医学会雑誌 |
| Volume | 35 |
| Number | 2 |
| Page | 292-297 |
| Year/Month | 2023 / 6 |
| Article | 原著 |
| Publisher | 日本新生児成育医学会 |
| Abstract | 「要旨」早期にヒトパレコウイルス3型脳炎と診断し, 感染経路を推定し得た早期発症の新生児症例を報告する. 症例は日齢7の女児. 発熱, 発疹, 無呼吸発作, 痙攣様の不随意運動を認めた. 頭部MRI拡散強調像で大脳白質・脳梁膨大部に高信号を認め, 日齢10の髄液フィルムアレイの結果からヒトパレコウイルス脳炎と診断し, 抗菌薬を中止した. 免疫グロブリン療法, ステロイドパルス療法を施行し, 痙攣様運動および無呼吸発作は改善し日齢27に退院した. 退院後の経過で頭部MRI所見も改善し月齢相当の発達が見られている. 母親と姉の便からヒトパレコウイルスが検出され, 出産前後の経過から出産前に姉から母親へ, 出産後に母親から児へ水平感染したと推察した. 新生児や乳児期早期に発熱や発疹, 無呼吸発作, 痙攣などの症状を呈した場合は, ヒトパレコウイルス感染を疑い, 速やかに診断することで予後を改善できる可能性があると考えられる. |
| Practice | 臨床医学：内科系 |
| Keywords | human parechovirus type 3, newborn, encephalitis, film array, infection route |
English
| Title | A Neonatal Case of Encephalitis by Human Parechovirus Type 3 That Onset at Age 7 Days |
|---|---|
| Subtitle | |
| Authors | Takumi OKAMURA, Akihiro KIRIMURA, Hajime YASUHARA, Reiko EBISU, Ayako OHGITANI, Hideki MINOWA |
| Authors (kana) | |
| Organization | Department of Neonatal Intensive Care Unit, Nara Prefecture General Medical Center |
| Journal | Journal of Japan Society for Neonatal Health and Development |
| Volume | 35 |
| Number | 2 |
| Page | 292-297 |
| Year/Month | 2023 / 6 |
| Article | Original article |
| Publisher | Japan Society for Neonatal Health and Development |
| Abstract | Here we report a case of early-onset human parechovirus type 3 encephalitis that was diagnosed early, and the likely route of infection. The patient was a 7-day-old girl who was admitted to the pediatric department due to fever, erythematous rash, apnea attack, and convulsive-like involuntary movements. Plain MRI of the head showed high signal level in the cerebral white matter and corpus callosum, and CSF Film Array at age 10 days was positive for human parechovirus. We therefore diagnosed human parechovirus encephalitis, and antimicrobial therapy was discontinued. Immunoglobulin therapy and steroid pulse therapy were administered. Afterwards, she showed no convulsive-like movements or apnea attack, and she was therefore discharged from the hospital at 27 days old. MRI findings of the head also improved, and the developmental follow-up revealed age-appropriate development. Human parechovirus was detected in stool samples of the patient's mother and older sister, and it was inferred that the infection was transmitted from her older sister to her mother, and then from her mother to the patient after childbirth. When neonates or infants present with symptoms such as fever, erythematous rash, apnea attack, or convulsions, human parechovirus infection should be suspected, and early diagnosis may improve the prognosis. |
| Practice | Clinical internal medicine |
| Keywords | human parechovirus type 3, newborn, encephalitis, film array, infection route |
- 全文ダウンロード： 従量制、基本料金制の方共に770円(税込) です。
参考文献
- 1) Ito M, Yamashita T, Tsuzuki H, et al. Isolation and identi-fication of a novel human parechovirus. J Gen Virol 2004 ; 85 : 391-398.
- 2) 野原史勝, 浅井洋子, 土田悦司他. Human parechovirus3型による新生児脳症の1例. 日周産期・新生児会誌 2012 ; 48 : 505.
- 3) 大府正治, 水野裕美子, 矢崎 幸他. 遅発性の深部白質異常を示すパレコウイルス3型新生児脳症の2例. 脳と発達 2011 ; 43 : S287.
- 4) Belcastro V, Bini P, Barachetti R, et al. Teaching neuroim-ages : neonatal parechovirus encephalitis : typical MRI findings. Neurology 2014 ; 82 : e23.
- 5) Chandran S, Arjun R, Sasidharan A, et al. Clinical Perfor-mance of FilmArray Meningitis/Encephalitis Multiplex Polymerase Chain Reaction Panel in Central Nervous Sys-tem Infections. Indian J Crit Care Med 2022 ; 26 : 67-70.
残りの11件を表示する
- 6) Aizawa Y, Suzuki Y, Watanabe K, et al. Clinical Utility of Serum Samples for Human Parechovirus Type 3 Infection in Neonates and Young Infants : The 2014 Epidemic in Japan. J Infect 2016 ; 72 : 223-232.
- 7) 横田俊平, 譲原佐栄子, 田中文子他. 新生児期に高熱を生じる新興感染症ヒト・パレコウイルスの病態-横浜市でみられた小流行からの考察. 日小児会誌 2012 ; 116 : 679-686.
- 8) Esposito S, Rahamat-Langendoen J, Ascolese B, et al. Pe-diatric parechovirus infections. J Clin Virol 2014 ; 60 : 84-89.
- 9) Ghanem-Zoubi N, Shiner M, Shulman LM, et al. Human parechovirus type 3 central nervous system infections in Israeli infants. J Clin Virol 2013 ; 58 : 205-210.
- 10) Harvala H, Griffiths M, Solomon T, et al. Distinct systemic and central nervous system disease patterns in enterovi-rus and parechovirus infected children. J Infect 2014 ; 69 : 69-74.
- 11) Aizawa Y, Watanabe K, Oishi T, et al. Role of Maternal Antibodies in Infants with Severe Diseases Related to Hu-man Parechovirus Type 3. Emerg Infect Dis 2015 ; 21 : 1966-1972.
- 12) Amarnath C, Mary TH, Periakarupan A, et al. Neonatal parechovirus leucoencephalitis-radiological pattern mim-icking hypoxic-ischemic encephalopathy. Eur J Radiol 2016 ; 85 : 428-434.
- 13) Aizawa Y, Yamanaka T, Watanabe K, et al. Asymptomat-ic children might transmit human parechovirus type 3 to neonates and young infants. J Clin Virol 2015 ; 70 : 105-108.
- 14) Nielsen NM, Midgley SE, Nielsen AC, et al. Severe human parechovirus infections in infants and the role of older sib-lings. Am J Epidemiol 2016 ; 183 : 664-670.
- 15) Khatami A, McMullan B, Webber M, et al. Sepsis-like dis-ease in infants due to human parechovirus type 3 during an outbreak in Australia. Clin Infect Dis 2015 ; 60 : 228-236.
- 16) Joseph L, May M, Thomas M, et al. Human parechovirus 3 in infants : Expanding our knowledge of adverse outcomes. Pediatr Infect Dis J 2019 ; 38 : 1-5.
