Human Parechovirus infection: An unexpected cause of neonatal liver failure

Abstract

Neonatal acute liver failure represents a critical pediatric emergency with significant mortality risk, demanding rapid diagnostic and therapeutic interventions. While gestational alloimmune liver disease, congenital infections, and metabolic disorders predominate as etiological factors, emerging viral pathogens like Human Parechovirus warrant careful consideration. We report a 23-day-old male presenting with classic hepatic distress symptoms—irritability, fever, and jaundice—confirmed to have Human Parechovirus-induced liver failure. Despite initial laboratory indicators suggesting severe hepatic compromise, including pronounced coagulopathy and marked functional derangement, aggressive supportive management facilitated a favorable clinical resolution. This observation underscores the critical importance of comprehensive viral screening and nuanced diagnostic approaches in managing complex neonatal hepatic pathologies.