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Neonatal parechovirus infection mimicking a surgical abdomen. Human parechovirus-3 (PeVA3) infection is a common cause of febrile illness in young infants and the spectrum of clinical presentation is broad. We describe a term infant who presented with marked abdominal distension and anorexia, concerning for an acute surgical abdomen. Evaluation revealed that the infant had PeVA3 infection. This case highlights the importance of recognising severe abdominal distension and discomfort as a clinical presentation associated with PeV and the potential utility of rapid testing for PeV.