Enterovirus neurological disease and bacterial coinfection in very young infants with fever.
Very little information exists on simultaneous infections by viruses and bacteria in infants with fever without source (FWS).



To investigate the incidence of bacterial coinfection in infants up to 3 months of age with neurological viral infection.



Prospective study performed in infants below 90 days of age attending the emergency room of two public hospitals in Spain for FWS. Those who had viral screening performed in CSF, together with blood, CSF and urine cultures were included. Herpes virus, EV and HPeV detection in CSF was performed by PCR. Coinfections between viruses in CSF and serious bacterial infections were described.



119 Infants less than 90 days of age were recruited. Forty-five (38%) had viral infection of the central nervous system, and in 8 of them (17.7%) we found a concurrent bacterial infection: 7 urinary tract infections (UTI) and 1 sepsis. In all cases, the virus identified in CSF was EV.



Bacterial infections were frequent in young infants with viral neurological infections associated to EV. Urinary tract infection was the most common bacterial disease.
Pediatrics Department, Hospital Severo Ochoa, Leganés, Madrid, Spain; Pediatric and Infectious Diseases, Hospital La Paz, La Paz Research Insititute (IdiPAZ), Madrid, Spain. Electronic address: ccalvorey@ono.com.
Cristina
C
Calvo
Pediatrics Department, Hospital Severo Ochoa, Leganés, Madrid, Spain. Electronic address: pau88_gp@hotmail.com.
Paula
P
Gallardo
Pediatrics Department, Hospital Severo Ochoa, Leganés, Madrid, Spain.
Patricia
P
Torija
Pediatrics Department, Hospital Severo Ochoa, Leganés, Madrid, Spain. Electronic address: sara.bellon.alonso@gmail.com.
Sara
S
Bellón
Pediatric and Infectious Diseases, Hospital La Paz, La Paz Research Insititute (IdiPAZ), Madrid, Spain. Electronic address: amendezes@yahoo.es.
Ana
A
Méndez-Echeverría
Pediatric and Infectious Diseases, Hospital La Paz, La Paz Research Insititute (IdiPAZ), Madrid, Spain. Electronic address: teredelrosal@yahoo.es.
Teresa
T
Del Rosal
Pediatric and Infectious Diseases, Hospital La Paz, La Paz Research Insititute (IdiPAZ), Madrid, Spain. Electronic address: fbaquero@terra.com.
Fernando
F
Baquero-Artigao
Pediatric and Infectious Diseases, Hospital La Paz, La Paz Research Insititute (IdiPAZ), Madrid, Spain. Electronic address: tsainzcosta@gmail.com.
Talía
T
Sainz
Laboratory of Microbiology, Hospital La Paz, Madrid, Spain. Electronic address: mromero.hulp@salud.madrid.org.
María
M
Romero
Enterovirus Unit, National Centre for Microbiology, Health Institute "Carlos III", Madrid, Spain. Electronic address: mcabrerizo@isciii.es.
María
M
Cabrerizo
D001424:Bacterial Infections / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D060085:Coinfection / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology / Q000821:virology; D004769:Enterovirus Infections / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008590:Meningoencephalitis / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology
Coinfection; Enterovirus; Fever; Infants; Meningitis; Urinary tract infections