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[Life-threatening echovirus 11 infection during first month of life]
U Rubinstein1, M Weisbrod, B Garty
1Neonatal Dept., Laniado Hospital, Kiriat Zans, Natanya.
Insights
Echovirus 11 infections can be severe in infants, causing sepsis-like illness, shock, and myocarditis. Prompt recognition and treatment are crucial for better outcomes in neonates.
Area of Science:
- Pediatric Infectious Diseases
- Neonatal Critical Care
- Virology
Background:
- Echovirus 11 (E11) infections are typically asymptomatic but can manifest as severe clinical diseases.
- In neonates, E11 can present as a sepsis-like illness, leading to disseminated intravascular coagulopathy (DIC) and shock.
Observation:
- Two cases of severe E11 infection in infants are presented.
- A 3.5-month-old infant died from shock and likely myocarditis within 24 hours.
- A 6-day-old infant presented with meningitis, hepatitis, and DIC, but recovered after intravenous immunoglobulin (IVIG) treatment.
Findings:
- Echovirus 11 poses a significant threat, causing life-threatening conditions in young infants.
- Severe E11 infection can rapidly progress to fatal outcomes, including shock and myocarditis.
- Intravenous immunoglobulin may be a potential treatment option for severe E11 infections in neonates.
Implications:
- Pediatricians must maintain a high index of suspicion for severe E11 infections in neonates.
- Early diagnosis and intervention are critical for managing E11-related critical illnesses in infants.
- Awareness of E11's potential for severe disease presentation is essential for pediatric healthcare providers.
Abstract:
Infection with Echovirus 11 is mostly asymptomatic, but it may cause a wide variety of clinical diseases, from gastroenteritis to serious diseases such as meningitis and myocarditis. In small infants, especially during the first days of life, echovirus infection may appear as a sepsis-like illness, and cause disseminated intravascular coagulopathy and shock. We present 2 infants with severe Echovirus 11 infections. A 3.5-month-old died within 24 hours of shock and probably myocarditis. The other, 6-days old, presented with meningitis, hepatitis and disseminated intravascular coagulopathy. It recovered after treatment with intravenous immunoglobulin. Echovirus 11 may cause life-threatening infections in small infants. Pediatricians should be alert to the special characteristics of this disease.