Epidemiology of Sepsis-like Illness in Young Infants: Major Role of Enterovirus and Human Parechovirus
Open accessAbstract
Background: Sepsis-like illness is a main cause for hospital admission in young infants. Our aim was to investigate incidence, epidemiology and clinical characteristics of enterovirus (EV) and human parechovirus (HPeV) infections in young infants with sepsis-like illness. Methods: This is a prospective observational cohort study in which infants younger than 90 days of age, presenting with sepsis-like symptoms in a secondary care children’s hospital, underwent a full sepsis work-up. Clinical signs and infectious indices were recorded. EV or HPeV RNA was detected by polymerase chain reaction in plasma and/or cerebrospinal fluid (CSF). Results: Infants were diagnosed with EV, HPeV, fever of unknown origin or severe infection. EV and HPeV were detected in 132 of 353 (37%) and 52 of 353 (15%) of cases, respectively. EV and HPeV have distinct seasonability. Some differences in clinical signs and symptoms occurred between children with EV and HPeV infection but were of limited clinical value. CSF pleocytosis occurred in 44% of EV positive infants, and only in 13% of those with HPeV infection. Conclusions: EV and HPeV infections are major causes of sepsis-like illness in infants < 90 days of age. Neither clinical characteristics nor laboratory indices were predictive for EV/HPeV infection. CSF pleocytosis occurs, but not in all patients. Testing for EV and HPeV in all young infants with sepsis-like illness is strongly advised.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In children aged <3 months, approximately 90% of those with HPeV-positive CSF and >50% of those with EV-positive CSF showed normal CSF cell counts, consistent with previous reports' results.
“In children aged <3 months, approximately 90% of those with HPeV-positive CSF and >50% of those with EV-positive CSF showed normal CSF cell counts, consistent with previous reports' results (21–25).”
From Epidemiology of pediatric meningitis and encephalitis in Japan: a cross-sectional study (2024) · cites this paper as [24]
Sepsis-like syndrome has been reported in 40-80% of HPeV (especially type 3) infections and 10-30% of EV infections in young infants.
“Sepsis-like syndrome has been reported in 40–80% of HPeV (especially type 3) infections and 10–30% of EV infections in young infants (21–27).”
From Epidemiology of pediatric meningitis and encephalitis in Japan: a cross-sectional study (2024) · cites this paper as [24]
Cites
Harvala, H., Robertson, I., Chieochansin, T., McWilliam Leitch, E. C., Templeton, K., & Simmonds, P. (2009) · The Journal of Infectious Diseases · doi:10.1086/599094 · Cited by 182 · see citing works
Lee, B. E., & Davies, H. D. (2007) · Current Opinion in Infectious Diseases · doi:10.1097/qco.0b013e3280ad4672 · Cited by 163 · see citing works
King, R. L., Lorch, S. A., Cohen, D. M., Hodinka, R. L., Cohn, K. A., & Shah, S. S. (2007) · Pediatrics · doi:10.1542/peds.2007-0252 · Cited by 98 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Epidemiology and Immune Pathogenesis of Viral Sepsis
Lin, G.-L., McGinley, J. P., Drysdale, S. B., & Pollard, A. J. (2018) · Frontiers in Immunology · doi:10.3389/fimmu.2018.02147 · Cited by 351 · see citing works
Eichinger, A., Hagen, A., Meyer-Bühn, M., & Huebner, J. (2019) · Infection · doi:10.1007/s15010-018-1212-7 · Cited by 60 · see citing works
Enteroviral infections in the first three months of life
Sandoni, M., Ciardo, L., Tamburini, C., Boncompagni, A., Rossi, C., Guidotti, I., Garetti, E., Lugli, L., Iughetti, L., & Berardi, A. (2022) · Pathogens · doi:10.3390/pathogens11010060 · Cited by 34 · see citing works
de Ceano-Vivas, M., García, M. L., Velázquez, A., Martín del Valle, F., Menasalvas, A., Cilla, A., Epalza, C., Romero, M. P., Cabrerizo, M., & Calvo, C. (2021) · Frontiers in Pediatrics · doi:10.3389/fped.2021.719119 · Cited by 22 · see citing works
Epidemiology of pediatric meningitis and encephalitis in Japan: a cross-sectional study
Mizuno, S., Kusama, Y., Otake, S., Ito, Y., Nozaki, M., & Kasai, M. (2024) · Microbiology Spectrum · doi:10.1128/spectrum.01192-24 · Cited by 6 · see citing works
- Authors
- de Jong, E. P., van den Beuken, M. G. A., van Elzakker, E. P. M., Wolthers, K. C., Sprij, A. J., Lopriore, E., Walther, F. J., & Brus, F.
- Affiliations
- Department of Medical Microbiology, Laboratory of Clinical Virology, Academic Medical Centre, Amsterdam, The Netherlands.
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Sprij, Arwen J.
- Brus, Frank
- Venue
- Pediatric Infectious Disease Journal
- Published
- 2018-02
- Volume
- 37
- Issue
- 2
- Pages
- 113-118
- ISSN
- 0891-3668 (ISSN-L)
- OpenAlex
- W2743938970
- Cited by
- 48
- References
- 3
- Citations by year
- 2026: 6 · 2025: 1 · 2024: 4 · 2023: 8 · 2022: 4 · 2021: 8 · 2020: 3 · 2019: 5 · 2018: 8 · 2017: 1
- FWCI
- 3.60
- Type
- journal article
- Language
- en
- Open access
- Locations
- The Pediatric Infectious Disease Journal (publishedVersion)
- PubMed (publishedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Leids Universitair Medisch Centrum
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Keywords
- sepsis-like illness, young infants, enterovirus infection, human parechovirus, fever of unknown origin, cerebrospinal fluid pleocytosis, seasonal variation, incidence, clinical features, diagnostic testing
- MeSH terms
- Enterovirus Infections, Enterovirus, Female, Humans, Infant, Infant, Newborn, Male, Netherlands, Picornaviridae Infections, Prospective Studies, Cohort Studies, Incidence, Prevalence, Polymerase Chain Reaction, Sepsis, Parechovirus
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
