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Suggest treatment for human parechoviruses in an infant

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Posted on Mon, 25 Jul 2016
Question: Our granddaughter who is 3 weeks old today (she was born on XXXXXXX 17) was diagnosed today with Human parechovirus. It showed up in her spinal fluid after a spinal tap. She was doing well following birth and she had gained one pound. She was 7 lbs. 12 ozs. at birth and she was 8 lbs. 12 ozs the day before she got sick. Her parents took her to the emergency room of our local hospital in western North XXXXXXX about 1 am after noting that the baby was lethargic, wouldn't nurse and she had a temp of 100.5 rectally. The doctor in our small town hospital sent the family to a bigger hospital where they had a pediatrician. He kept them there for almost 30 hours and when after trying and failing three times to get a spinal tap, they sent her by ambulance to our closest bigger hospital. The doctors said that she could get more specialized care there. The doctors we're able to get a spinal tap there about 24 hours ago. We found out this past afternoon that they had discovered this virus in the spinal fluid. The baby also has had a recurring fever and her oxygen level has gone down several times and it set off an alarm and it was even down to 55% so now the doctors have oxygen on her all the time. Our son told me this past evening that they haven't wanted her to nurse for a while because her stomach was getting distended. The pediatrician at the second hospital told our son and his wife that he suspected that the baby had viral encephalitis, They havenn't been told that at the 3rd hospital. We do suspect that she does have that and possibly even spinal meningitis if the meninges are invvolved and inflamed also. They heard that this virus that she has is extremely rare. My question for you is since it is so rare, do the doctors now how to treat it? And where did she get it? My daughter-in-law was diagnosed with Strep B during the pregnancy and she had to have an IV antibiotic prior to her delivery and I also think that she had another IV dose of antibiotic following her delivery. Could the virus still have come from the baby's mother? I won't tell her that even if it could be the cause because I would never want to have her feel that this could be her fault. She is the nicest young woman I know and I would not want to hurt her. Our son told me about 10 hours ago that the next two days are very critical for the baby. We are all very distraught over the whole medical situation. The family pastor went to the hospital which is 200 miles away from us and baptized and anointed the baby yesterday. We feel good about that. We know that she is extremely ill and what is the prognosis of such this terrible medical illness? Thank you so much for any information you can give me regarding this medical situation.
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Answered by Dr. Sumanth Amperayani (30 minutes later)
Brief Answer:
This is definitely not due to the infection the mother had

Detailed Answer:
Hi... I understand your concern. Coming to your queries one by one -

1. This is definitely viral encephalitis due to Human parecho virus. This is a serious sort of viral encephalitis.

2. Any viral encephalitis - the question of whether the doctors know to treat or not - doesn't arise because - it is only supportive management. There are only two viruses for which there is specific treatment or drug (Herpes and Enteroviruses). For rest of the viruses it is only symptomatic and supportive management with wait and watch policy and act accordingly as the clinical situation warrants.

3. It is very difficult to know or guess where she got it from. But it is definitely not related to the Group B streptococcal infection your daughter-in-law had. The transmission is usually through - Faecal-oral route or respiratory secretions or surfaces / fomites. The best way of prevention is hand washing before handling the kids.

Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.
Dr. Sumanth MBBS., DCH., DNB (Paed).,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sumanth Amperayani (20 minutes later)
HOW LONG WILL OUR GRANDDAUGHTER BE SICK WITH THIS VIRUS AND WHEN WILL WE KNOW IF SHE HAS LASTING EFFECTS FROM IT?
doctor
Answered by Dr. Sumanth Amperayani (20 minutes later)
Brief Answer:
How long the sickness lasts cannot be expected - might have seizures

Detailed Answer:
Hi...How long the sickness cannot be expected as of now. It all depends upon how the baby reacts to the viral illness and how much the brain is affected by this illness.

We will get to know about the long term effects while we follow her developmental milestones, if she develops seizures then it depends on her seizure control. Not only this - in future she will need an MRI brain to check if she has got any gliosis or a sort of fibrosis of the brain tissue.

I wish your kid a speedy recovery. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Once the page opens there will be an option below my image as – ASK ME A QUESTION – click on it. In this way even in health care magic you can follow up always with a single doctor who knows the history of your kid completely. Please find the link below -

www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 8316 Questions

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Suggest treatment for human parechoviruses in an infant

Brief Answer: This is definitely not due to the infection the mother had Detailed Answer: Hi... I understand your concern. Coming to your queries one by one - 1. This is definitely viral encephalitis due to Human parecho virus. This is a serious sort of viral encephalitis. 2. Any viral encephalitis - the question of whether the doctors know to treat or not - doesn't arise because - it is only supportive management. There are only two viruses for which there is specific treatment or drug (Herpes and Enteroviruses). For rest of the viruses it is only symptomatic and supportive management with wait and watch policy and act accordingly as the clinical situation warrants. 3. It is very difficult to know or guess where she got it from. But it is definitely not related to the Group B streptococcal infection your daughter-in-law had. The transmission is usually through - Faecal-oral route or respiratory secretions or surfaces / fomites. The best way of prevention is hand washing before handling the kids. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. Dr. Sumanth MBBS., DCH., DNB (Paed).,