Introduction Enterovirus (EV) or Human Parechovirus (HPeV) infections are common causes of sepsis-like illness in young children. We investigated differences in incidence, clinical characteristics and management of EV and HPeV infections among young children with sepsis-like illness.
Methods In 2008 158 children under 36 months of age presenting with sepsis-like symptoms at the Juliana Children’s Hospital in The Hague, the Netherlands, were evaluated in a prospective observational study. All received a sepsis work up including white cell count, CRP, blood culture and urine screening. Cerebrospinal fluid (CSF) was collected on clinical indication. EV or HPeV DNA was detected by PCR in plasma and/or CSF. Urine cultures were performed when urine screening was positive. 10 children with urinary tract infection were excluded. Data of the remaining 148 children were analysed.
Results EV/HPeV PCR was performed in 122/148 children: 45 (37%) were EV positive and 22 (18%) HPeV positive. The most prominent difference between children with EV and HPeV was age. HPeV was solely diagnosed in children under 126 days of age. Clinical characteristics at presentation did not differ. Children with HPeV had lower leukocyte counts and lower CRP values. No difference in clinical management was found between EV and HPeV positive children.
Conclusion Sepsis-like illness due to EV and HPeV infection is common in young children, and appeared in 37% and 18% of cases respectively. HPeV occurs in younger children and causes less elevation of infectious parameters than EV infection. All other clinical characteristics are similar. Clinical management does not differ.