人A3型Parechovirus引起新生儿脓毒症伴明显高铁蛋白血症1例

IF 0.5 Q4 PEDIATRICS
Case Reports in Pediatrics Pub Date : 2025-09-18 eCollection Date: 2025-01-01 DOI:10.1155/crpe/8815738
Fumihiro Ochi, Mao Niida, Ayumi Sawada, Kozo Nagai, Hitomi Hino, Koji Takemoto, Hisamichi Tauchi
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引用次数: 0

摘要

背景:在新生儿和婴幼儿中,人乳头状瘤病毒A3 (PeV-A3)与严重感染相关,如败血症和脑脊髓炎。然而,严重疾病背后的机制和适当的适应症和治疗方法仍然不明确。病例报告:一名健康的25日龄女性,因高热、咆哮声和饮食不良入院。经检查,患者出现嗜睡和昏睡,表现为心动过速、呼吸急促和外周性冷。包括FilmArray脑膜炎/脑炎小组在内的脓毒症评估证实存在PeV-A3感染。开始氨苄西林和头孢噻肟的经验性抗生素治疗。第4天发烧消退,阴性细菌培养表明不再需要抗生素。然而,在第5天,患者出现血小板计数下降、肝酶升高和高铁蛋白血症(铁蛋白水平为37223 ng/mL)。尽管高铁蛋白水平,但未观察到噬血细胞性淋巴组织细胞增多症(HLH),患者未接受免疫抑制治疗。病情好转,于第14天出院。分离得到的PeV基因型为PeV- a3。结论:PeV-A3感染常与高铁蛋白血症有关。虽然一些研究表明类固醇和免疫抑制剂可能是有益的,但这个病例表明,即使铁蛋白水平很高,勤奋的观察也是足够的。监测临床状态和实验室结果以评估是否需要治疗是至关重要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Neonatal Sepsis Caused by Human Parechovirus Type A3 With Marked Hyperferritinemia: A Case Report.

Background: In neonates and young infants, human parechovirus A3 (PeV-A3) is associated with severe infections, such as sepsis and encephalomyelitis. However, the mechanisms behind severe illness and the proper indications and methods for treatment remain ambiguous. Case Report: A previously healthy 25-day-old female was admitted to our hospital with a history of high-grade fever, a growling voice, and poor feeding. Upon examination, she appeared lethargic and somnolent, exhibiting symptoms of tachycardia, tachypnea, and peripheral coolness. Sepsis evaluations, including the FilmArray Meningitis/Encephalitis panel, confirmed the presence of PeV-A3 infection. Empirical antibiotic therapy with ampicillin and cefotaxime was started. The fever subsided by Day 4, and a negative bacterial culture indicated that antibiotics were no longer necessary. However, on Day 5, the patient experienced a drop in platelet count, elevated liver enzymes, and hyperferritinemia (ferritin level of 37,223 ng/mL). Despite the high ferritin levels, hemophagocytic lymphohistiocytosis (HLH) was not observed, and the patient was treated without immunosuppressive therapy. Her condition improved, and she was discharged on Day 14. The isolated PeV was genotyped as PeV-A3. Conclusions: PeV-A3 infections often link to hyperferritinemia. Although some studies indicate that steroids and immunosuppressants might be beneficial, this case shows that diligent observation could be adequate, even with high ferritin levels. Monitoring clinical status and lab results to assess whether treatment is necessary is crucial.

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11.10%
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