2018 Volume 46 Issue 2 Pages 63-68
A 9-year-old girl under treatment for Mycoplasma infection developed a fever, began vomiting, and exhibited abnormal behavior The number of cells in the cerebrospinal fluid were increased, and high-amplitude δ waves were found on the electroencephalogram. Diffusion-weighted magnetic resonance imaging images of her head showed an abnormally high signal in the cerebral cortex. After 2 treatments with steroid pulse therapy, intravenous γ immunoglobulin, antibiotics therapy, and antiviral therapy as treatment for encephalitis, her consciousness improved and her ability to perform activities of daily living level had not decreased at the time of discharge. PCR testing of her cerebrospinal fluid revealed type 3 parechovirus, and blood and cerebral spinal fluid tests showed elevation of GluN2B-NT2, GluN2B-CT, GluN1-NT, and GluD2-NT antibodies. Human parechovirus is common as a virus causing sepsis and encephalitis in neonates and infants. There is no case report of parechovirus encephalitis in school-aged children. Careful follow-up is necessary because glutamate receptors can be deeply involved in memory and learning.
