Parechovirus is generally asymptomatic in older children and can cause symptoms similar to that of the common cold. However, in infants less than 3 months, infection can be severe with seizures and sepsis-like presentations. Currently, there are no good treatments. Some providers have administered IVIG, but the efficacy is unknown. Most patients will recover with supportive care, however neonates can have long-term consequences. The Parechovirus A3 strain has been more prevalent in circulation over the summer of 2022, such that the Center for Disease Control and Prevention has issued a health alert about the unusually high prevlalence of the A3 strain in neonates and young infants. We present a case of meningoencephalitis with unique imaging findings on MRI with Parechovirus detection in CSF studies. Although few descriptions exist within the radiology literature, our case has MRI imaging characteristics are nearly identical to that of a case series published in the American Journal of Neuroradiology in August 2019. Given the increased prevalence of this virus and radiology findings consistent with the prior publication, the imaging findings on MRI can prove to be vital in assisting with the diagnosis of patients where CSF cannot be obtained.
SPR 2023 Annual Meeting & Postgraduate Course