Fatal enteroviral infection in a neonate

Enterovirus infection has been recognized as one of the most common viral infections in the perinatal and neonatal periods. It frequently leads to significant mortality. One fatal case of neonatal enteroviral infection was experienced in last year. The patient was a one-day-old male, presenting with neonatal sepsis. He has a biphasic illness, first with a mild febrile prodrome then followed by severe systemic involvement, with meningitis, myocarditis, hepatosplenomegaly and disseminated intravascular coagulation. All bacterial cultures were negative, but the rectal swab isolated enterovirus. The echocardiogram revealed depressed cardiac function, and he finally expired at the age of 10 days. The autopsy findings supported the diagnosis of perinatal enteroviral infection (coxsackievirus B infection was highly suspected). Clinically, if a neonate presents as sepsis, but has the following conditions, enteroviral infection should be considered: (1) negative bacterial cultures; (2) multiple organ involvement; (3) proven enteroviral infection in the same nursery or ward; (4) a mild febrile illness in the mother within the last antepartum 10 days or the first postpartum 5 days; (5) any family members with fever or signs of upper respiratory infection within 15 days before delivery.