Fatal coxsackievirus B infection in early infancy characterized by fulminant hepatitis.
OBJECTIVE
to clarify the major features of fatal coxsackievirus B infection characterized by fulminant hepatitis in early infancy.


METHODS
clinical manifestations and laboratory investigations concerning five consecutive young infants with overwhelming coxsackievirus B fulminant hepatitis between 1994 and 1997 were retrospectively reviewed. Aetiological diagnosis was made by viral cultures and confirmed by a neutralization test with a type-specific antiserum.


RESULTS
all five had a deteriorating clinical course of severe hepatitis complicated by disseminated intravascular coagulopathy (DIC). Coxsackievirus B1 infection was established in four patients and coxsackievirus B3 in one. The pathological findings of the two cases illustrated extensive hepatocellular necrosis. Fulminant hepatitis can occur as a leading presentation of disseminated coxsackievirus B infections and dominant the clinical features in neonates and young infants.


CONCLUSIONS
the liver was the target organ of fatal coxsackievirus B infection in our patients. Hepatic involvement progressed rapidly to jaundice and coagulopathy, and was considered to be indicative of poor prognosis. Coxsackievirus B hepatitis may be serious in early infancy.
Wang
S M
SM
Department of Paediatrics, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan.
Liu
C C
CC
Yang
Y J
YJ
Yang
H B
HB
Lin
C H
CH
Wang
J R
JR
D003384:Coxsackievirus Infections / Q000150:complications* / Q000821:virology; D029822:Enterovirus B, Human / Q000302:isolation & purification*; D017809:Fatal Outcome; D005260:Female; D006505:Hepatitis / Q000150:complications*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000473:pathology; D008297:Male; D012189:Retrospective Studies