Sun W, Huang F Y, Hung H Y
Department of Pediatrics, Mackary Memorial Hospital, Taitung Branch, Taiwan, R.O.C.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1993 Nov-Dec;34(6):492-5.
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.
肠道病毒感染已被公认为围产期和新生儿期最常见的病毒感染之一。它常导致显著的死亡率。去年有一例新生儿肠道病毒感染的致命病例。该患者为一名1日龄男婴，表现为新生儿败血症。他患有一种双相性疾病，首先是轻度发热前驱症状，随后是严重的全身受累，伴有脑膜炎、心肌炎、肝脾肿大和弥散性血管内凝血。所有细菌培养均为阴性，但直肠拭子分离出肠道病毒。超声心动图显示心脏功能减退，他最终在10日龄时死亡。尸检结果支持围产期肠道病毒感染的诊断（高度怀疑为柯萨奇病毒B感染）。临床上，如果新生儿表现为败血症，但有以下情况，应考虑肠道病毒感染：（1）细菌培养阴性；（2）多器官受累；（3）同一托儿所或病房证实有肠道病毒感染；（4）母亲在产前最后10天或产后第1天至5天内有轻度发热性疾病；（5）分娩前15天内任何家庭成员有发热或上呼吸道感染症状。
