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Neonatal coxsackie B virus infection—a treatable disease?

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Abstract

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). Conclusion: 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.

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Abbreviations

DIC :

disseminated intravascular coagulopathy

IVIG :

intravenous immunoglobulin

PCR :

polymerase chain reaction

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Authors and Affiliations

  1. Paediatric Infectious Diseases Unit, Department of Microbiology and Infectious Diseases, Royal Children’s Hospital, Parkville, Australia

    Penelope A. Bryant, Mike Starr & Nigel Curtis

  2. Department of Neonatology, Royal Children’s Hospital, Parkville, Australia

    David Tingay & Peter A. Dargaville

  3. Paediatric Infectious Diseases Unit, Department of Paediatrics, University of Melbourne, Royal Children’s Hospital, VIC 3052, Parkville , Australia

    Nigel Curtis

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  1. Penelope A. Bryant
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  2. David Tingay
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  4. Mike Starr
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  5. Nigel Curtis
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Correspondence to Nigel Curtis.

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Bryant, P.A., Tingay, D., Dargaville, P.A. et al. Neonatal coxsackie B virus infection—a treatable disease?. Eur J Pediatr 163, 223–228 (2004). https://doi.org/10.1007/s00431-004-1408-y

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  • DOI: https://doi.org/10.1007/s00431-004-1408-y

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