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Clinical Characteristics of Saffold Virus Infection in Children

Ugai, Satoko MD*; Iwaya, Atsushi MD; Taneichi, Hiromichi MD, PhD; Hirokawa, Chika§; Aizawa, Yuta MD, PhD; Hatakeyama, Shuji MD, PhD; Saitoh, Akihiko MD, PhD

The Pediatric Infectious Disease Journal: August 2019 - Volume 38 - Issue 8 - p 781–785
doi: 10.1097/INF.0000000000002298
Original Studies

Background: Saffold virus (SAFV) is a novel human cardiovirus that was identified in 2007. Recently, SAFV has been isolated from nasal and stool specimens of infants presenting with respiratory and gastrointestinal symptoms and from cerebrospinal fluid (CSF) specimens of children with central nervous system infection. However, little is known regarding clinical characteristics of SAFV in children.

Methods: We reviewed 5412 specimens from the database of the infectious agents surveillance system in Niigata prefecture, Japan, between January 2006 and December 2013, and identified SAFV-infected patients. Subsequently, we retrospectively reviewed their medical records and evaluated their clinical characteristics.

Results: We identified 9 SAFV-infected patients (median age: 5 years; range: 2–16 years). Seven patients were diagnosed with pharyngitis, one with meningitis and one with fever of unknown origin. Dominant symptoms were high fever, appetite loss and headache. The median duration of the fevers was 2 days in patients with pharyngitis; however, the patient with meningitis remained febrile for 5 days. All blood tests available in this case series revealed leukocytosis with a predominance of neutrophils. CSF profiles showed mild lymphocytic pleocytosis. All patients recovered fully without complications.

Conclusions: A few clinical characteristics of SAFV infection were clarified, including high fever of short duration in patients with pharyngitis, and neutrophil-dominant leukocytosis. The clinical course and CSF profiles of a case of meningitis were similar to those of other aseptic meningitis. SAFV needs to be included in the differential diagnosis of pharyngitis or meningitis when commonly identified viruses are not identified in such patients.

From the *Department of Pediatrics, Tokamachi Prefectural Hospital, Tokamachi, Niigata, Japan

Department of Pediatrics, Ryotsu Hospital, Sado, Niigata, Japan

Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan

§Department of Virology, Niigata Prefectural Institute of Public Health and Environmental Science and

Department of Pediatrics, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan

Division of General Internal Medicine/Infectious Diseases, Jichi Medical University Hospital, Tochigi, Japan.

Accepted for publication January 23, 2019.

The authors have no conflicts of interest to disclose.

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Address for correspondence: Satoko Ugai, MD, Department of Pediatrics, Tokamachi Prefectural Hospital, Takadachou, Tokamachi, Niigata, 948-0065, Japan. E-mail:

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