Parechovirus Neonatal Meningitis: A Case Report

Neonatal meningitis is a serious, potentially life- threatening condition that requires prompt diagnosis and treatment. Bacterial pathogens are usual suspects; however, viral cause should not be overlooked. We report a case of Parechovirus neonatal meningitis in an 8 days old male infant, emphasizing the importance of considering uncommon viral pathogens in the diagnostic work up. Human Parechovirus belongs to the family of Picornaviridae virus. It is very uncommon and has been associated with a benign clinical course of respiratory and gastrointestinal infection in most cases, however, it is emerging as one of the causes for emergency admission of neonates in hospital due to certain serotypes. The HPeV type 3 has been found mostly in children and young infants presenting with meningitis and sepsis like illness. Infants with severe Central Nervous System (CNS) infections are at an increased risk of long-term sequelae. In this case we describe the clinical presentation, diagnostic challenges, management and outcome of this rare infection. An 8 days old baby presented to our emergency department with sepsis like illness. He was admitted in neonatal unit for further investigations and management. Despite initial presentation the inflammatory markers were normal. Symptomatic-supportive treatment was given till baby made full recovery. Antibiotics were discontinued after 48 hours as culture was negative for bacteria. This case highlights the importance of considering Parechovirus as possible cause of neonatal meningitis when inflammatory markers are normal and plan the management appropriately.