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RT Journal Article
SR Electronic
T1 Human Parechovirus Meningoencephalitis: Neuroimaging in the Era of Polymerase Chain Reaction–Based Testing
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1418
OP 1421
DO 10.3174/ajnr.A6118
VO 40
IS 8
A1 Sarma, A.
A1 Hanzlik, E.
A1 Krishnasarma, R.
A1 Pagano, L.
A1 Pruthi, S.
YR 2019
UL http://www.ajnr.org/content/40/8/1418.abstract
AB SUMMARY: Human parechovirus infection is an increasingly recognized cause of neonatal meningoencephalitis. We describe characteristic clinical features and brain MR imaging abnormalities of human parechovirus meningoencephalitis in 6 infants. When corroborated by increasingly available polymerase chain reaction–based testing of the CSF, the distinctive MR imaging appearance may yield a specific diagnosis that obviates costly and time-consuming further clinical evaluation. In our study, infants with human parechovirus presented in the first 35 days of life with seizures, irritability, and sepsis. MR imaging consistently demonstrated low diffusivity within the thalami, corpus callosum, and subcortical white matter with a frontoparietal predominance. T1 and T2 shortening connoting white matter injury along the deep medullary veins suggests venous ischemia as an alternative potential pathogenetic mechanism to direct neuroaxonal injury.HPeVhuman parechovirusPCRpolymerase chain reaction