Neonatal coxsackievirus B1 infection associated with severe hepatitis: report of three cases

Coxsackievirus B infection may cause fulminant disease in the neonate. In most reports the prominent symptoms have been recognized as myocarditis and meningoencephalitis, and a majority were caused by type B2 to B5. Coxsackie B1 was a rare cause. From December 1993 to April 1994 three newborns were admitted to this Hospital with similar presentations of acute hepatitis and thrombocytopenia. Coxsackie B1 virus was isolated from all at one or two sites including rectal swab, throat swab and urine. One fatal case had had symptoms from birth; the disease progressed rapidly initially with a strikingly high liver enzyme; respiratory failure was noted; acute renal failure then happened later and the baby expired in two weeks. The other two patients survived, though one also had severe fulminant hepatitis. In that case onset of the disease was late at 28 days old. The other's clinical course was mild from the beginning. Myocarditis or central nervous system involvement were apparently not the significant presentations. Because the three babies all came from areas near this city (Chung-Ho and Pan-Chiao), attention should be drawn to the prevalence of coxsackie B1 virus infection in the total community.