Encephalitis Related to Human Parechovirus Type 3
Bibliographic record
Abstract
Human parechoviruses belong to the Picornaviridae family and are classified into 17 genotypes. Recently, it has been reported that human parechovirus genotype 3 is an important cause of severe infections, including sepsis-like illness and encephalitis, especially in newborns and infants younger than 3 months. There are also reports that human parechovirus genotype 3 infections with central nervous system symptoms lead to high rates of neurological sequelae and death. Here, we report a case of a previously healthy 1-month-old girl who developed encephalitis related to human parechovirus genotype 3 and had a favorable outcome. The patient presented septicemic symptoms, including fever, tachycardia, tachypnea with retractions and seizures without an elevated inflammatory response. She lacked cerebrospinal fluid pleocytosis but had hypercytokinemia. Brain magnetic resonance imaging and electroencephalography showed abnormal findings. Together, these findings strongly suggested acute encephalopathy. She underwent emergency intubation for respiratory failure and mechanical ventilation was started. Intravenous phenobarbital injection was performed to prevent convulsion. She was treated using intravenous immunoglobulin with methylprednisolone pulse therapy. As of 2 years after discharge, her growth development is equivalent to her age and she has had no clinical epileptic seizures. In this case, human parechovirus genotype 3 was detected from pharyngeal swabs, stool, cerebrospinal fluid and blood by polymerase chain reaction assay. The patient was diagnosed definitively with encephalitis related to human parechovirus genotype 3. The symptoms that we observed should be considered for the differential diagnosis of human parechovirus infection. When a patient is suspected of having encephalitis related to human parechovirus, treatment including intravenous immunoglobulin and corticosteroid must be started as soon as possible to prevent neurodevelopmental sequelae. Int J Clin Pediatr. 2019;8(2):37-40 doi: https://doi.org/10.14740/ijcp333
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".