背景:非脊髓灰质炎肠道病毒(EV)和人副病毒(HPeV)是新生儿脑膜脑炎的已知病原体。然而,有关该人群的神经放射学结果和神经发育结局的报告很少.
目的:描述临床特征,神经放射学发现和,在一部分患者中,一组60天内患有EV或HPeV脑膜脑炎的婴儿的神经发育结局。
方法:临床/实验室数据,神经放射学发现(头颅超声,cUS,脑磁共振成像,MRI),前瞻性收集第三版问卷-年龄和阶段评估的神经发育结局。
结果:总体,纳入32例EV(21,67.8%)或HPeV(11,28.2%)脑膜脑炎患儿。患有HPeV(73%:3型HPeV)的婴儿更频繁地出现癫痫发作(18.2%vs.0,p值=0.03),淋巴细胞减少症(1120vs.2170细胞/mm3,p=0.02),脑电图(EEG)局灶性异常(63.6vs.23.8%,p=0.03),和MRI病理发现(72.7%vs.15.8%,p值=0.004)与受EV影响的值相比。任何入选婴儿的cUS均无显著改变.所有在12-24个月和30-48个月评估的EV脑膜脑炎婴儿均正常。在30-48个月大的7名HPeV脑膜脑炎婴儿中,有2名在粗大运动功能(1/7,14.3%)或解决问题(1/7,14.3%)方面表现出担忧。
结论:在我们的队列中,感染HPeV的新生儿有更严重的临床表现,大脑MRI的更多改变,和一些长期神经发育迟缓的迹象。我们的数据强调了EV或HPeV脑膜脑炎婴儿表现的异质性,以及在新生儿期需要对感染HPeV的人进行长期随访。
BACKGROUND: Non-polio enteroviruses (EV) and human parechoviruses (HPeV) are known etiological agents of meningoencephalitis in neonates. However, reports of neuroradiological findings and neurodevelopmental outcomes in this population are scarce.
OBJECTIVE: to describe clinical characteristics, neuroradiological findings and, in a subset of patients, neurodevelopmental outcomes in a cohort of infants with EV or HPeV meningoencephalitis within 60 days of life.
METHODS: clinical/laboratory data, neuroradiological findings (cranial ultrasound, cUS, brain magnetic resonance imaging, MRI), and neurodevelopmental outcomes assessed by Ages and Stages Questionnaires - third edition were prospectively collected.
RESULTS: overall, 32 infants with EV (21, 67.8 %) or HPeV (11, 28.2 %) meningoencephalitis were enrolled. Infants with HPeV (73 %: type 3 HPeV) presented more frequently with seizures (18.2 % vs. 0, p value=0.03), lymphopenia (1120 vs. 2170 cells/mm3, p = 0.02), focal anomalies at electroencephalography (EEG) (63.6 vs. 23.8 %, p = 0.03), and pathological findings at MRI (72.7 % vs. 15.8 %, p value=0.004) compared to those affected by EV. cUS was not significantly altered in any of the enrolled infants. All infants with EV meningoencephalitis evaluated at 12-24 months and at 30-48 months were normal. Two out of the 7 infants with HPeV meningoencephalitis showed some concerns in gross motor (1/7, 14.3 %) or in problem solving (1/7, 14.3 %) function at 30-48 months of age.
CONCLUSIONS: In our cohort, neonates infected by HPeV had more severe clinical manifestations, more alterations at brain MRI, and some signs of long-term neurodevelopmental delay. Our data highlight the heterogeneity of manifestations in infants with EV or HPeV meningoencephalitis, and the need for long-term follow-up of those infected by HPeV in the neonatal period.