Scientific letter
Could human bocavirus be a causative agent of parotitis in children?
¿Puede ser el bocavirus humano un agente causal de parotiditis en niños?
Cristina Calvoa,b,c,
, Claudia Millana, María Pilar Romerod, Ana Méndez-Echevarríaa,b
Corresponding author
a Pediatric Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Spain
b Fundación IdiPaz, Madrid, Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
c TEDDY Network (European Network of Excellence for Pediatric Clinical Research), Italy
d Microbiology Department, Hospital Universitario La Paz, Madrid, Spain
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class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Could human bocavirus be a causative agent of parotitis in children?" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "207" "paginaFinal" => "208" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Cristina Calvo, Claudia Millan, María Pilar Romero, Ana Méndez-Echevarría" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Cristina" "apellidos" => "Calvo" "email" => array:1 [ 0 => "ccalvorey@gmail.com" ] "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Claudia" "apellidos" => "Millan" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "María Pilar" "apellidos" => "Romero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 3 => array:3 [ "nombre" => "Ana" "apellidos" => "Méndez-Echevarría" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Pediatric Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Fundación IdiPaz, Madrid, Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "TEDDY Network (European Network of Excellence for Pediatric Clinical Research), Italy" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Microbiology Department, Hospital Universitario La Paz, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "¿Puede ser el bocavirus humano un agente causal de parotiditis en niños?" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Parotitis is usually associated with mumps viral infections, but since trivalent measles–mumps–rubella vaccine started to be administrated in different countries, the burden of the disease has been steadily reduced. Nowadays the parotitis cases are usually related to other viral infections in countries with high vaccination coverage.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,2</span></a> Although Epstein Barr virus (EBV) has been recognized as the most frequently detected microorganism, other respiratory viruses such as parainfluenza virus (PIV) or adenovirus<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> have been described associated with parotitis.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The human bocavirus (HBoV) has been identified in respiratory infections in children in a large number of studies, mainly in infants less than 2 years of age during late autumn<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> being recurrent wheezing episodes and fever the most frequent symptomatology. To date, only two cases of parotitis have been reported associated with bocavirus infection, one of which being a coinfection with PIV 3.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,2</span></a> These two cases were detected in two prospective studies that surveyed the frequency of several viruses in sporadic parotitis in Korea and U.S.A. The authors observed an incidence of HBoV infection of 0.4–1% in their studied cases.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We report a child with parotitis and an acute respiratory tract infection in whom HBoV was the only virus identified.</p><p id="par0020" class="elsevierStylePara elsevierViewall">A 17-month-old male, with a history of recurrent wheezing presented at the emergency room in November with 48<span class="elsevierStyleHsp" style=""></span>h of left parotid swelling. He had had fever for a few hours (maximum 39.2<span class="elsevierStyleHsp" style=""></span>°C), and respiratory distress that had not improved despite receiving bronchodilators and amoxicillin-clavulanate for two days. Physical examination revealed high fever, left parotid inflammation without erythema, expiratory wheezing and hypoxaemia, requiring admission and treatment with bronchodilators and oxygen therapy. The chest X-ray demonstrated an infiltrate in the right middle lobe. Cervical ultrasound revealed an enlarged left parotid gland, with multiple internal lesions of low echogenicity in relation to intraglandular inflammatory changes. Intraglandular adenopathy and bilateral laterocervical chains were also observed. The blood test showed normal haemoglobin and platelets; 13,000 leukocytes (44% neutrophils); C-reactive protein 41<span class="elsevierStyleHsp" style=""></span>mg/L and amylase 381<span class="elsevierStyleHsp" style=""></span>U/L. Blood culture was negative, and a multiplex polymerase chain reaction in nasopharyngeal aspirate taken at admission (CLART<span class="elsevierStyleSup">®</span> Pneumovir array assay that identifies adenovirus, metapneumovirus A,B, parinfluenza 1,2,3,4, rhinovirus, respiratory syncytial virus A,B, bocavirus, influenza A,B,C, enterovirus and coronavirus 229E, OC43 & NL63) was positive for HBoV. Mumps serology detected negative IgM and positive IgG titres. He remained afebrile during admission, with improvement in his respiratory distress and disappearance of parotid swelling, then being discharged within 3 days.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Two weeks after admission the patient was asymptomatic, cervical ultrasound was normal except for some intraparotid adenopathy, and amylase titre was 77<span class="elsevierStyleHsp" style=""></span>U/L. Control nasopharyngeal aspirate in this moment was negative.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Human bocavirus has been associated with lower respiratory tract infections, mainly wheezing and pneumonia, in young children.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3–5</span></a> It has also been described as a causative agent of upper respiratory tract infections, mainly adenoiditis and otitis, demonstrating its affinity with this type of tissues.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6,7</span></a> To date, only in two cases has HBoV been associated with mumps but its pathogenic role as a causative agent of parotitis is discussed, since in one case it has been detected in coinfection with PIV 3.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,2</span></a> However, the parotid gland could be a target of infection for this virus, as occurs in adenoids, where some authors have identified HBoV in up to 43% of the specimens obtained from children with adenoidal disease.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Our patient had the typical symptomatology associated with HBoV infections with a wheezing episode, and with infiltrate in the chest X-ray. In addition, he was in the most frequent age-range for this virus infection, developing the disease during late autumn when most HBoV infections occur.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> The analytical data were also consistent with those described in HBoV infections.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> Bacterial agents were not detected. He was correctly vaccinated and mumps serology showed the presence of IgG titres. Acute EBV infection was also ruled out. The clinical picture evolved favourably and the nasopharyngeal aspirate control was negative two weeks after the acute episode. Although causality of HBoV is difficult to establish, serology has demonstrated that HBoV has a pathogenic role in respiratory infections.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">8–10</span></a> Unfortunately in our centre we do not have HBoV serology available, but we think that our case adds to those already described to make it consider that it may have an etiological role.</p><p id="par0040" class="elsevierStylePara elsevierViewall">We consider that HBoV should be taken into consideration as an infrequent but possible causative agent of acute parotitis in young children. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 4 | 5 | 9 |
| 2024 September | 31 | 3 | 34 |
| 2024 August | 17 | 3 | 20 |
| 2024 July | 19 | 4 | 23 |
| 2024 June | 21 | 3 | 24 |
| 2024 May | 12 | 5 | 17 |
| 2024 April | 14 | 7 | 21 |
| 2024 March | 12 | 3 | 15 |
| 2024 February | 7 | 1 | 8 |
| 2024 January | 10 | 1 | 11 |
| 2023 December | 17 | 5 | 22 |
| 2023 November | 27 | 3 | 30 |
| 2023 October | 13 | 0 | 13 |
| 2023 September | 19 | 1 | 20 |
| 2023 August | 21 | 0 | 21 |
| 2023 July | 32 | 4 | 36 |
| 2023 June | 37 | 1 | 38 |
| 2023 May | 58 | 4 | 62 |
| 2023 April | 59 | 0 | 59 |
| 2023 March | 28 | 4 | 32 |
| 2023 February | 17 | 1 | 18 |
| 2023 January | 20 | 2 | 22 |
| 2022 December | 14 | 4 | 18 |
| 2022 November | 22 | 11 | 33 |
| 2022 October | 13 | 7 | 20 |
| 2022 September | 16 | 3 | 19 |
| 2022 August | 13 | 4 | 17 |
| 2022 July | 11 | 6 | 17 |
| 2022 June | 19 | 9 | 28 |
| 2022 May | 9 | 5 | 14 |
| 2022 April | 8 | 5 | 13 |
| 2022 March | 32 | 6 | 38 |
| 2022 February | 34 | 6 | 40 |
| 2022 January | 38 | 6 | 44 |
| 2021 December | 27 | 5 | 32 |
| 2021 November | 19 | 9 | 28 |
| 2021 October | 22 | 9 | 31 |
| 2021 September | 9 | 6 | 15 |
| 2021 August | 8 | 7 | 15 |
| 2021 July | 29 | 6 | 35 |
| 2021 June | 18 | 6 | 24 |
| 2021 May | 11 | 11 | 22 |
| 2021 April | 25 | 12 | 37 |
| 2021 March | 12 | 8 | 20 |
| 2021 February | 10 | 11 | 21 |
| 2021 January | 11 | 7 | 18 |
| 2020 December | 9 | 6 | 15 |
| 2020 November | 7 | 10 | 17 |
| 2020 October | 5 | 3 | 8 |
| 2020 September | 11 | 6 | 17 |
| 2020 August | 7 | 6 | 13 |
| 2020 July | 4 | 7 | 11 |
| 2020 June | 10 | 7 | 17 |
| 2020 May | 9 | 5 | 14 |
| 2020 April | 3 | 2 | 5 |
| 2020 March | 17 | 2 | 19 |
| 2020 February | 9 | 3 | 12 |
| 2020 January | 11 | 5 | 16 |
| 2019 December | 10 | 6 | 16 |
| 2019 November | 6 | 5 | 11 |
| 2019 October | 7 | 8 | 15 |
| 2019 September | 6 | 12 | 18 |
| 2019 March | 2 | 0 | 2 |
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