title: Enteroviral myocarditis in neonates.
abstract: Enteroviruses are a leading cause of viral infections in children. While most enteroviral infections are mild and self-limiting, severe disease such as a viral sepsis syndrome, myocarditis, hepatitis and meningoencephalitis may occur. We present two cases of neonatal enteroviral myocarditis. Cardiorespiratory failure occurred in both cases, and severe shock refractory to conventional treatment required support with extracorporeal membrane oxygenation (ECMO). One child with coxsackievirus B3 myocarditis failed to recover and died after 3 weeks on ECMO, while one child could be decannulated successfully after 9 days of ECMO and recovered completely subsequently. In conclusion, neonatal myocarditis has a very high mortality, and ECMO should be considered early in neonates with rapid clinical and echocardiographic deterioration despite adequate inotropic support.
authors.affiliation: Paediatric Intensive Care Unit, Mater Children's Hospital, Brisbane, Queensland, Australia.
authors.forename: Luregn J
authors.initials: LJ
authors.lastname: Schlapbach
authors.forename: Joerg
authors.initials: J
authors.lastname: Ersch
authors.forename: Christian
authors.initials: C
authors.lastname: Balmer
authors.forename: René
authors.initials: R
authors.lastname: Prêtre
authors.forename: Maren
authors.initials: M
authors.lastname: Tomaske
authors.forename: Rosmarie
authors.initials: R
authors.lastname: Caduff
authors.forename: Jim
authors.initials: J
authors.lastname: Morwood
authors.forename: Sylvio
authors.initials: S
authors.lastname: Provenzano
authors.forename: Christian
authors.initials: C
authors.lastname: Stocker
mesh_terms: D003384:Coxsackievirus Infections / Q000150:complications / Q000175:diagnosis; D004769:Enterovirus Infections / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D015199:Extracorporeal Membrane Oxygenation; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009205:Myocarditis / Q000175:diagnosis / Q000628:therapy / Q000821:virology*; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000628:therapy / Q000821:virology*
keywords: coxsackievirus; enterovirus; extracorporeal membrane oxygenation; myocarditis; neonate