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http://dx.doi.org/10.14776/piv.2019.26.e16

Early Detection and Successful Treatment of Vertically Transmitted Fulminant Enteroviral Infection Associated with Various Forms of Arrhythmia and Severe Hepatitis with Coagulopathy

Lee, So Ra (Department of Pediatrics, Cheil General Hospital & Women's Health Care Center, Dankook University College of Medicine)
Ko, Sun Young (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Yoon, So Young (Department of Pediatrics, Cheil General Hospital & Women's Health Care Center, Dankook University College of Medicine)
Lee, Yeon Kyung (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
Shin, Son Moon (Department of Pediatrics, Cheil General Hospital & Women's Health Care Center, Dankook University College of Medicine)

Publication Information

Pediatric Infection and Vaccine / v.26, no.3, 2019 , pp. 199-205 More about this Journal

Abstract

Enteroviral infections are common in neonates. One important infection pathway is vertical transmission from an infected mother to her neonate. Here, we report the early detection and successful treatment of a vertically transmitted fulminant enteroviral infection associated with myocarditis and hepatitis. The patient had a sudden onset of high fever on the fourth day of life and developed severe, rapidly progressing symptoms of disseminated intravascular coagulopathy (DIC), hepatitis, and myocarditis accompanied by tachyarrhythmia. As it was the peak season for enteroviral infections and both the mother and the patient's 36-month-old sibling had a high fever around the time of delivery, we suspected an enteroviral infection. Thus, we initiated prompt evaluation of enteroviral infection, as well as close observation and intensive care of the neonate. We strongly recommend evaluation for the possibility of vertical enterovirus infection in neonates when the mother is suspected of having a viral infection (e.g., high fever and negative results from bacterial infectious studies) around the time of delivery and when the neonate shows some early symptoms of infectious diseases such as thrombocytopenia, DIC, hepatitis, and myocarditis. Early detection of enteroviral infections and prompt implementation of proper treatment are key to reduce the risk of complications and mortality associated with enteroviral infections in neonates.

Keywords

Enterovirus; Myocarditis; Arrhythmias, cardiac; Hepatitis; Infant, newborn;

Citations & Related Records

Reference

1	Zaoutis T, Klein JD. Enterovirus infections. Pediatr Rev 1998;19:183-91. DOI
2	Schlapbach LJ, Ersch J, Balmer C, Pretre R, Tomaske M, Caduff R, et al. Enteroviral myocarditis in neonates. J Paediatr Child Health 2013;49:E451-4. DOI
3	Yen MH, Huang YC, Chen MC, Liu CC, Chiu NC, Lien R, et al. Effect of intravenous immunoglobulin for neonates with severe enteroviral infections with emphasis on the timing of administration. J Clin Virol 2015;64:92-6. DOI
4	Banjac L, Nikcevic D, Vujosevic D, Raonic J, Banjac G. Tachycardia in a newborn with enterovirus infection. Acta Clin Croat 2014;53:102-6.
5	Bryant PA, Tingay D, Dargaville PA, Starr M, Curtis N. Neonatal coxsackie B virus infection-a treatable disease? Eur J Pediatr 2004;163:223-8. DOI
6	Kaga A, Katata Y, Suzuki A, Otani K, Watanabe H, Kitaoka S, et al. Perinatal coxsackievirus B3 infection with transient thrombocytopenia. Tohoku J Exp Med 2016;239:135-8. DOI
7	Haston JC, Dixon TC. Nonpolio enterovirus infections in neonates. Pediatr Ann 2015;44:e103-7. DOI
8	Takahashi H, Tsukamoto K, Takahashi S, Nakamura T, Ito Y, Kaneko M, et al. Reversible atrioventricular block and junctional ectopic tachycardia in coxsackievirus B3-induced fetal-neonatal myocarditis without left ventricular dysfunction. AJP Rep 2011;1:37-42. DOI
9	Batra AS, Chun DS, Johnson TR, Maldonado EM, Kashyap BA, Maiers J, et al. A prospective analysis of the incidence and risk factors associated with junctional ectopic tachycardia following surgery for congenital heart disease. Pediatr Cardiol 2006;27:51-5. DOI
10	Tebruegge M, Curtis N. Enterovirus infections in neonates. Semin Fetal Neonatal Med 2009;14:222-7. DOI
11	Abzug MJ, Michaels MG, Wald E, Jacobs RF, Romero JR, Sanchez PJ, et al. A randomized, double-blind, placebo-controlled trial of pleconaril for the treatment of neonates with enterovirus sepsis. J Pediatric Infect Dis Soc 2016;5:53-62. DOI
12	Anderson BR, Silver ES, Richmond ME, Liberman L. Usefulness of arrhythmias as predictors of death and resource utilization in children with myocarditis. Am J Cardiol 2014;114:1400-5. DOI