A recent article published in the Journal of Microbiology, Immunology, and Infection stated that enteroviruses generally cause mild and self-limited diseases, but they have been found to affect neonates much differently and often more severely than older children. Clinical appearances are difficult to differentiate from those of bacterial sepsis, such as fever, poor feeding, lethargy, respiratory distress and cardiovascular collapse. Severe life-threatening complications, including hepatic necrosis with coagulopathy, meningoencephalitis and myocarditis that usually present during the first week of life. Factors affecting severity and outcome include virus serotype, mode of transmission and the presence or absence of passively acquired, serotype-specific maternal antibodies.

The authors reported that echoviruses and coxsackievirus B viruses are most common serotypes associated with the neonatal sepsis. An alertness of the clinical syndromes, recognition of the risk factors and monitoring parameters associated with severe cases and use of rapid reverse-transcriptase polymerase chain reaction test for viral load may help physicians in diagnosing severe cases in a timely manner. In addition, prompt aggressive treatment including early intravenous immunoglobulin treatment may help in reducing morbidity and mortality.

This article further discussed that Enterovirus infections in neonates are common and should be routinely considered in the differential diagnosis of febrile neonates, particularly during enterovirus season.

Source: Journal of Microbiology, Immunology, and Infection. 2019 Dec; 52(6):851-857. doi: 10.1016/j.jmii.2019.08.018.