title: Case of a healthy infant born following antenatal enterovirus myocarditis and hydrops.
abstract: Fetal hydrops and myocarditis were diagnosed in a woman at 32 weeks of gestation (WG). Transplacental enterovirus infection was suspected because all other causes of myocarditis and hydrops were excluded, it was during an endemic period, and there was a setting of maternal infection (fever a few days before). We opted for in utero treatment because of the risk of resuscitating a neonate with myocarditis and hydrops. We administered dexamethasone 12mg twice for pulmonary maturation and presumed it would partially improve the myocarditis. Fetal arrhythmia was noted at 35 WG and we decided to deliver the infant as postnatal treatment of the heart disorder would be more effective. RT-PCR (ARGENE(®)) showed that the neonate's throat and anal tissues and cord blood sampled on the day of birth contained enterovirus ribonucleic acid and coxsackievirus B5, as did the mother's anal sample. Laboratory tests, heart MRI and probably brain MRI indicated neonatal enterovirus infection. Findings were normal at two-year follow-up.
authors.affiliation: Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Antoine Béclère, AP-HP, Université Paris Sud, Clamart, France.
authors.forename: Aurore
authors.initials: A
authors.lastname: Bonnin
authors.affiliation: Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Antoine Béclère, AP-HP, Université Paris Sud, Clamart, France.
authors.forename: Mikael
authors.initials: M
authors.lastname: Tassin
authors.affiliation: Service de Virologie, Hôpital Paul Brousse, AP-HP, CNR Infections Rubéoleuses Materno-Fœtales, Université Paris-Sud, UMR-S 785, INSERM U785, Villejuif 94804, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Vauloup-Fellous
authors.affiliation: Service de Néonatologie, Hôpital Antoine Béclère, AP-HP, Université Paris Sud, Clamart, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Letamendia
authors.affiliation: Service de Cardiologie, Hôpital Marie Lannelongue, Université Paris Sud, Le Plessis Robinson, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Stos
authors.affiliation: Service de Cardiologie, Hôpital Necker-Enfants Malades, AP-HP, Université René Descartes, Paris, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Bonnet
authors.affiliation: Service de Pédiatre, Hôpital Antoine Béclère, AP-HP, Université Paris Sud, Clamart, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Gajdos
authors.affiliation: Service de Radiologie, Hôpital Antoine Béclère, AP-HP, Université Paris Sud, Clamart, France.
authors.forename: Mylène
authors.initials: M
authors.lastname: Mabille
authors.affiliation: Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Antoine Béclère, AP-HP, Université Paris Sud, Clamart, France. Electronic address: alexandra.benachi@abc.aphp.fr.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Benachi
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000821:virology; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D004487:Edema / Q000150:complications / Q000175:diagnosis* / Q000209:etiology*; D004770:Enterovirus / Q000145:classification / Q000302:isolation & purification; D004769:Enterovirus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D005312:Fetal Blood / Q000821:virology; D005315:Fetal Diseases / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009205:Myocarditis / Q000150:complications / Q000175:diagnosis* / Q000209:etiology*; D010614:Pharynx / Q000821:virology; D011296:Prenatal Diagnosis
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone
keywords: Antenatal; Enteroviruses; Healthy infant; Hydrops; Myocarditis