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Intracerebroventricular and Intravascular Injection of Viral Particles and Fluorescent Microbeads into the Neonatal Brain
Published on: July 24, 2016
[EARLY ENTEROVIRUS NEONATAL INFECTION: WHEN SHOULD WE THINK ABOUT IT?]
Abstract:
Enterovirus (EV) may cause a broad spectrum of clinical syndromes and even cause a sepsis-like picture. Although they are responsible for high morbidity and mortality rates, viral testing does not appear in the algorithms for the evaluation of neonatal infections. During the month of June 2013, we identified 3 cases of EV meningitis in our unit of neonatology. All three infants had fever during the first week of life and their clinical examination revealed an irritability. The EV infection was detected by Real-Time Polymerase Chain Reaction (RT-PCR) EV on the cerebrospinal fluid (CSF). Two of the patients also had a positive RT-PCR EV in the blood. The 3 newborns were discharged from the hospital after a few days with no adverse outcome. Our clinical observations and the literature review suggest that EV infections in neonates ought to be identified as soon as possible by an early RT-PCR EV on the blood, and on the CSF if a lumbar puncture is indicated. This could help reduce the administration of antibiotics and the length of hospital stay.
Insights
Early detection of enterovirus (EV) infections in newborns using Real-Time Polymerase Chain Reaction (RT-PCR) is crucial. Prompt EV testing can reduce antibiotic use and hospital stays for neonatal meningitis.
Area of Science:
- Neonatal infectious diseases
- Virology
- Clinical microbiology
Background:
- Enterovirus (EV) infections can lead to severe neonatal syndromes, including sepsis-like presentations.
- Current diagnostic algorithms for neonatal infections often overlook timely viral testing.
- EVs are associated with significant neonatal morbidity and mortality rates.
Observation:
- Three cases of enterovirus meningitis were identified in neonates within the first week of life.
- Affected infants presented with fever and irritability.
- Enterovirus infection was confirmed via Real-Time Polymerase Chain Reaction (RT-PCR) on cerebrospinal fluid (CSF), with blood RT-PCR positive in two cases.
Findings:
- All three neonates recovered without adverse outcomes and were discharged shortly after.
- Early identification of EV infections is critical for appropriate management.
- RT-PCR testing on blood and CSF can facilitate rapid diagnosis.
Implications:
- Implementing early EV RT-PCR testing in blood and CSF can improve neonatal outcomes.
- Timely diagnosis may reduce unnecessary antibiotic administration.
- Early detection can potentially shorten the duration of hospitalization for affected newborns.
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