Miyoshi Yasuhiro, Yoshioka Sachika, Gosho Hirokazu, Miyazoe Shoichi, Suenaga Hideyo, Aoki Mikihiro, Hashimoto Kunio
Department of Pediatrics, National Hospital Organization, Nagasaki Medical Center, Nagasaki, Japan.
Department of Pediatrics, Nagasaki University, Graduate School of Biomedical Sciences, Nagasaki, Japan.
IDCases. 2020 Feb 29;20:e00738. doi: 10.1016/j.idcr.2020.e00738. eCollection 2020.
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening syndrome of excessive immune activation that most commonly affects infants. We report the case of a term female neonate with HLH associated with coxsackievirus B3 Infection. Her mother was hospitalized due to high fever 4 days before the delivery. The patient was delivered by vaginal delivery after the induction of labor. She was admitted to the neonatal care unit due to continuous high fever and poor sucking on her 4 day of life. She developed apnea on her 5 day of life. Laboratory findings on the patient's 7 day of life indicated severe thrombocytopenia, liver dysfunction, coagulation abnormality and hyperferritinemia. Coxsackievirus B3 was isolated from all cultured specimens by the PCR method. She received intravenous transfusion of platelets and immunoglobulin. Her platelet count gradually increased to the normal range by her 14 day of life and she was discharged without any sequelae on her 25 day of life. To the best of our knowledge, this is the first case report of neonatal HLH associated with a vertical transmission of coxsackievirus B3. Coxsackievirus is an important virus that can cause HLH in neonates. An early diagnosis and timely treatment are crucial.
噬血细胞性淋巴组织细胞增生症（HLH）是一种危及生命的过度免疫激活综合征，最常影响婴儿。我们报告一例足月女新生儿患HLH并伴有柯萨奇病毒B3感染的病例。患儿母亲在分娩前4天因高热住院。患儿经引产通过阴道分娩。出生后第4天，因持续高热和吸吮无力入住新生儿重症监护病房。出生后第5天出现呼吸暂停。出生后第7天的实验室检查结果显示严重血小板减少、肝功能障碍、凝血异常和高铁蛋白血症。通过聚合酶链反应（PCR）方法从所有培养标本中分离出柯萨奇病毒B3。患儿接受了血小板和免疫球蛋白静脉输注。出生后第14天血小板计数逐渐升至正常范围，出生后第25天出院，无任何后遗症。据我们所知，这是首例关于新生儿HLH与柯萨奇病毒B3垂直传播相关的病例报告。柯萨奇病毒是一种可导致新生儿HLH 的重要病毒。早期诊断和及时治疗至关重要。
