Parechovirus Sepsis and Meningitis in a Neonatal Intensive Care Unit

The majority of febrile neonates have negative bacterial cultures and presumed viral infections. During November 2014, four febrile neonates in southeastern Wisconsin required intensive care admission for human parechovirus (HPeV) infection in the blood and/or cerebral spinal fluid (CSF). Both vertical and horizontal transmission led to disease, and a variety of signs and symptoms, including tachycardia, hypotension, neutropenia, rash and irritability accompanied fever. All neonates recovered clinically, although concern for neurodevelopmental delay remains for those with meningoencephalitis. This case series describes the presentation and short-term outcomes of neonates requiring intensive care for HPeV infections.