Pediatric Bocavirus Clinical Presentation
- Author: Nicholas John Bennett, MBBCh, PhD, MA(Cantab), FAAP; Chief Editor: Russell W Steele, MD more...
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- No distinction between confirmed, apparently isolated bocavirus-associated disease and any other nonspecific viral respiratory infection has been established.
- The most consistently reported symptoms include cough, fever, and rhinorrhea.
- A higher-than-expected rate of GI symptoms has been noted, with as many as 25% of patients experiencing some form of gastroenteritis. Other known pathogens were detected along with human bocavirus in 58% of stool samples in one study from Spain. HBoV2 has been detected at a high frequency (17.2%) in stool samples of children with acute gastroenteritis, but also in a significant number (8.1%) of healthy controls.
- Several reports of isolated human bocavirus in patients with wheezing episodes suggest that it primarily causes obstructive respiratory disease, is a secondary inflammatory response (similar to respiratory syncytial virus), or acts as a trigger to patients who are susceptible to reactive airways, such as those with preexisting asthma.
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- The physical examination findings are similar to those of a typical viral respiratory infection.
- Patients with more severe lower respiratory tract disease may have wheezing, tachypnea, grunting (in younger children), and use of accessory muscles.
- Children with severe gastroenteritis may show signs of dehydration: poor skin turgor, sunken eyes, lethargy. A decrease in urine output (manifesting as fewer wet diapers in young infants) and a lack of tears when crying may be noticed.
Allander T, Tammi MT, Eriksson M, et al. Cloning of a human parvovirus by molecular screening of respiratory tract samples. Proc Natl Acad Sci U S A. 2005 Sep 6. 102(36):12891-6. [Medline].
Schildgen O, Müller A, Allander T, Mackay IM, Völz S, Kupfer B, et al. Human bocavirus: passenger or pathogen in acute respiratory tract infections?. Clin Microbiol Rev. 2008 Apr. 21(2):291-304, table of contents. [Medline]. [Full Text].
Chow BD, Ou Z, Esper FP. Newly recognized bocaviruses (HBoV, HBoV2) in children and adults with gastrointestinal illness in the United States. J Clin Virol. 2010 Feb. 47(2):143-7. [Medline].
Arthur JL, Higgins GD, Davidson GP, Givney RC, Ratcliff RM. A novel bocavirus associated with acute gastroenteritis in Australian children. PLoS Pathog. 2009 Apr. 5(4):e1000391. [Medline]. [Full Text].
Dijkman R, Koekkoek SM, Molenkamp R, Schildgen O, van der Hoek L. Human bocavirus can be cultured in differentiated human airway epithelial cells. J Virol. 2009 Aug. 83(15):7739-48. [Medline]. [Full Text].
Lassauniére R, Kresfelder T, Venter M. A novel multiplex real-time RT-PCR assay with FRET hybridization probes for the detection and quantitation of 13 respiratory viruses. J Virol Methods. 2010 Feb 11. [Medline].
Allander T, Jartti T, Gupta S, et al. Human bocavirus and acute wheezing in children. Clin Infect Dis. 2007 Apr 1. 44(7):904-10. [Medline].
Fry AM, Lu X, Chittaganpitch M, Peret T, et al. Human bocavirus: a novel parvovirus epidemiologically associated with pneumonia requiring hospitalization in Thailand. J Infect Dis. 2007 Apr 1. 195(7):1038-45. [Medline].
Lehtoranta L, Soderlund-Venermo M, Nokso-Koivisto J, et al. Human bocavirus in the nasopharynx of otitis-prone children. Int J Pediatr Otorhinolaryngol. 2012 Feb. 76(2):206-11. [Medline].
Blessing K, Neske F, Herre U, Kreth HW, Weissbrich B. Prolonged detection of human bocavirus DNA in nasopharyngeal aspirates of children with respiratory tract disease. Pediatr Infect Dis J. 2009 Nov. 28(11):1018-9. [Medline].
Deng Y, Gu X, Zhao X, et al. High viral load of human bocavirus correlates with duration of wheezing in children with severe lower respiratory tract infection. PLoS One. 2012. 7(3):e34353. [Medline]. [Full Text].
Korner RW, Soderlund-Venermo M, van Koningsbruggen-Rietschel S, Kaiser R, Malecki M, Schildgen O. Severe human bocavirus infection, Germany. Emerg Infect Dis. 2011 Dec. 17(12):2303-5. [Medline]. [Full Text].
Edner N, Castillo-Rodas P, Falk L, Hedman K, Söderlund-Venermo M, Allander T. Life-threatening respiratory tract disease with human bocavirus-1 infection in a 4-year-old child. J Clin Microbiol. 2012 Feb. 50(2):531-2. [Medline]. [Full Text].
Mitui MT, Tabib SM, Matsumoto T, et al. Detection of human bocavirus in the cerebrospinal fluid of children with encephalitis. Clin Infect Dis. 2012 Apr. 54(7):964-7. [Medline].
Korppi M. Polymerase chain reaction in respiratory samples alone is not a reliable marker of bocavirus infection. Pediatr Pulmonol. 2013 Oct 24. [Medline].
Brebion A, Vanlieferinghen P, Déchelotte P, Boutry M, Peigue-Lafeuille H, Henquell C. Fatal sub-acute myocarditis associated with human bocavirus 2 in a 13-month-old child. J Clin Microbiol. 2013 Dec 26. [Medline].
Mori D, Ranawaka U, Yamada K, Rajindrajith S, Miya K, Perera HK, et al. Human bocavirus in patients with encephalitis, Sri Lanka, 2009-2010. Emerg Infect Dis. 2013 Nov. 19(11):1859-62. [Medline]. [Full Text].
Endo R, Ishiguro N, Kikuta H, Teramoto S, Shirkoohi R, Ma X, et al. Seroepidemiology of human bocavirus in Hokkaido prefecture, Japan. J Clin Microbiol. 2007 Oct. 45(10):3218-23. [Medline].
Vicente D, Cilla G, Montes M, et al. Human bocavirus, a respiratory and enteric virus. Emerg Infect Dis. 2007 Apr. 13(4):636-7. [Medline].
Ma X, Endo R, Ishiguro N, et al. Detection of human bocavirus in Japanese children with lower respiratory tract infections. J Clin Microbiol. 2006 Mar. 44(3):1132-4. [Medline].
Volz S, Schildgen O, Klinkenberg D, et al. Prospective study of Human Bocavirus (HBoV) infection in a pediatric university hospital in Germany 2005/2006. J Clin Virol. 2007 Nov. 40(3):229-35. [Medline].
Kapoor A, Simmonds P, Slikas E, et al. Human bocaviruses are highly diverse, dispersed, recombination prone, and prevalent in enteric infections. J Infect Dis. 2010 Jun 1. 201(11):1633-43. [Medline].