Neonatal coxsackie B virus infection-a treatable disease?
Ten neonates with coxsackie B viral infection presented over a 3-month period. Clinical features included meningoencephalitis, thrombocytopenia, disseminated intravascular coagulopathy, cardiomyopathy, and hepatitis. Eight infants had multiorgan disease, four with severe myocardial dysfunction, of whom two died. All of the infants with severe disease developed symptoms within 7 days of age. In infants presenting within 10 days of birth, in all cases there were symptoms compatible with maternal infection prior to delivery. Severity was associated with perinatal transmission. Enteroviral polymerase chain reaction of CSF, urine, stool or throat swab was positive in nine of the ten babies. Seven of the infants were treated with a 7-day course of the new anti-picornaviral drug pleconaril (5 mg/kg 3 times daily).


CONCLUSIONS
These cases highlight the importance of not missing coxsackie B viral infection in the differential diagnosis of the septic neonate, especially as there is now a potential treatment.
Bryant
Penelope A
PA
Paediatric Infectious Diseases Unit, Department of Microbiology and Infectious Diseases, Royal Children's Hospital, Parkville, Australia.
Tingay
David
D
Dargaville
Peter A
PA
Starr
Mike
M
Curtis
Nigel
N
D000998:Antiviral Agents / Q000627:therapeutic use; D009202:Cardiomyopathies / Q000209:etiology; D003384:Coxsackievirus Infections / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D029822:Enterovirus B, Human / Q000187:drug effects / Q000235:genetics; D006505:Hepatitis / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D018445:Infectious Disease Transmission, Vertical; D008590:Meningoencephalitis / Q000209:etiology; D010069:Oxadiazoles / Q000627:therapeutic use; D010080:Oxazoles; D018743:Perinatal Care; D016133:Polymerase Chain Reaction; D013921:Thrombocytopenia / Q000209:etiology
D000998:Antiviral Agents; D010069:Oxadiazoles; D010080:Oxazoles; C115201:pleconaril