小児感染免疫第27巻第4号
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1 2015 小児感染免疫 Vol. 27 No human parechovirus HPeV RNA 1, HPeV1HPeV HPeV136 HPeV16 HPeV HPeV HPeV Key wordsrnahuman parechovirus, sepsis, circulatory failure, RNA virus, infection of the central nervous system
2 HPeV MRI 3,18,19 HPeV polymerase chain reaction PCR PCR HPeV HPeV HPeV HPeV PCR MinElute PCR Purification kitqiagen RNA PCR Thermal Cycler Dice PCR 20 PCR , SIRSsystemic inflammatory response syndrome 22 65SIRS 2005 Goldstein ,000l CRP 1.0 mgdl AST 44 IUlALT 21 IUlLDH 293 IUlCPK 103 IU l 2.3 mmoll 1 CRP 1.0 mgdl 6 LDH 700 IUl 2 CPK 400 IUl 1 HPeVPCR 13
3 2015 小児感染免疫 Vol. 27 No n , SIRS l 5,0502,0909,810 l CRPmgdl ASTIUl ALTIUl LDHIUl ,006 CPKIUl ,176 mgdl mmoll l 5044 mgdl gdl bolus bolus mlkg ICU ECMOCHDF Goldstein bpm min 10 3 l or or or or or or or 6 SIRS or PCR CRTcapillary refilling time
4 CRT MRI 2,090l bolus 28.1 mlkg 1060 mlkg 1 ECMOextracorporeal membrane oxygenation CHDFcontinuous hemodiafiltration CTXABPC 18 53CTX CTXVCM 4 12 ACV 11 32Cefotaxime CTXAmpicillinABPCVancomycinVCM AcyclovirACV HPeVPCR
5 2015 小児感染免疫 Vol. 27 No HPeV 3 HPeV3 HPeV3 RGD 17, HPeV3 34 HPeV3 25,26 viral sepsis HPeV3 9,14 SIRS 6 SIRS CRT 14 HPeV viral sepsis HPeV3 CRT HPeV HPeV 27, Romero 67 8 HPeVPCR HPeV 80
6 Bangalore HPeV HPeV HPeV 29,31 Il1 IL6 CRP HPeV 6 34 SIRS ,32 1 LDH 1,006 IUlCK 3,176 IUl 6,13,17 3 HPeV 1Harvala H, et alparechoviruses in children understanding a new infection. Cur Opin Infect Dis , JokiKorpela P, et alparechoviruses, a novel group of human picornaviruses. Ann Med , Harvala H, et alhuman parechovirusesbiology, epidemiology and clinical significance. J Clin Virol 4519, Wang C, et alcomplete genome sequence of a novel human parechovirus. J Virol , S Human ParechovirusHPeV HPeV 3 HPeV Rath A, et alparechovirus as a cause of a sepsislike syndrome with cerebral involvement in a 7week old infant. Klin Padiatr ,
7 2015 小児感染免疫 Vol. 27 No Davis J, et alhuman parechovirus infection in neonatal intensive care. Pediatr Infect Dis J , Khatami A, et alsepsislike disease in infants due to human Parechovirus type3 during an outbreak in Australia. Clin Infect Dis , Romero JR, et althe human Parechoviruses an overview. Adv Pediatr , Wolthers KC, et alhuman parechoviruses as an important viral cause of sepsislike illness and meningitis in young children. Clin Infect Dis , Ito M, et aldetection of human parechoviruses from clinical stool samples in Aichi, Japan. J Clin Microbiol , Han TH, et alhuman parechovirus3 infection in children, South Korea. J Clin Virol , Benschop KS, et alhuman parechovirus infections in Dutch children and the association between serotype and disease severity. Clin Infect Dis , GhanemZoubi N, et alhuman parechovirus type 3 central nervous system infections in Israeli infants. J Clin Virol , Brownell AD, et alhuman Parechovirus3 encephalitis in two neonatesacute and follow up magnetic resonance imaging and evaluation of central nervous system markers of inflammation. Pediatr Neurol , Nix WA, et aldetection of all known parechoviruses by realtime PCR. J Clin Microbiol , Goldstein B, et alinternational pediatric sepsis consensus conferencedefinitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med 628, Ito M, et alisolation and identification of a novel human parechovirus. J Gen Virol , AlSunaidi M, et alanalysis of a new human parechovirus allows the definition of parechovirus types and the identification of RNA structural domains. J Virol , JokiKorpela P, et aldiagnosis and epidemiology of echovirus 22 infections. Clin Infect Dis , Human ParechovirusHPeV IASR Sharp J, et alcharacteristics of young infants in whom human parechovirus, enterovirus or neither were detected in cerebrospinal fluid during sepsis evaluations. Pediatr Infect Dis J , Westerhuis BM, et alspecific cell tropism and neutralization of human parechovirus types1 and 3implications for pathogenesis and therapy development. J Gen Virol , Shoji K, et aldermatologic manifestations of human parechovirus type3 infection in neonates and infants. Pediatr Infect Dis J , Bangalore H, et alabdominal distensionan important feature in human parechovirus infection. Pediatr Infect Dis J ,
8 Clinical characteristics of 34 pediatric cases of human parechovirus infection at four hospitals in Japan Shun KISHIBE 1, Hanako YAMANOUCHI 1, Mihoko ISOGAI 2, Masako FUKUSHIMA 2, Hiroki SAKURAI 2, Shintaro HIROTAKI 2, Saeko MORINO 3, Kenta ITO 2, Yoshie IWASE 4, Yoshiaki CHO 5, Masashi KASAI 5, Meiwa TOYOFUKU 7, Yuho HORIKOSHI 2 1Department of General Pediatrics, Tokyo Metropolitan Childrens Medical Center 2Department of Infectious Disease, Tokyo Metropolitan Childrens Medical Center 3Infectious Diseases Surveillance Center, National Institute of Infectious Diseases 4Department of Pediatrics, Sendai City Hospital 5Department of General Pediatrics, Nagano Childrens Hospital 6Department of Critical Care Medicine, Nagano Childrens Hospital 7Department of Pediatrics, Yokohama Rosai Hospital Clinical characteristics of 34 pediatric patients diagnosed with human parechovirus infection were investigated between 2013 and 2014 at four hospitals in Japan. Ninety four percent of the patients3234were less than 3 months of age. Clinical presentations of circulatory failure and central nervous system manifestations were observed in 94 and 68, respectively. Rash and abdominal distension were observed later in the course in 44 and 21, respectively. Laboratory findings were generally nonspecific at admission. Human parechovirus infection should be included in differential diagnosis of febrile patients aged 3 months or younger who present with circulatory failure and or central nervous system manifestations
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