Top

BMC Pediatrics

Published in:

Open Access 01-12-2021 | Coxsackievirus | Research article

Clinical characteristics of severe neonatal enterovirus infection: a systematic review

Authors: Meng Zhang, Haoran Wang, Jun Tang, Yang He, Tao Xiong, Wenxing Li, Yi Qu, Dezhi Mu

Published in: BMC Pediatrics | Issue 1/2021

Abstract

Background

Enterovirus (EV) is a common cause of infection in neonates. Neonates are at high risk of enterovirus infection with serious clinical manifestations and high lethality. This review systematically summarized the clinical characteristics of neonates with severe enteroviral infection to provide evidence for the identification and treatment of severe neonatal EV infection.

Methods

PubMed, Embase, and Web of Science were searched for original studies on neonates with severe EV infections from January 1, 2000, to November 27, 2020. Two reviewers independently screened the literature, extracted the data, and performed a descriptive analysis.

Results

In total, 66 articles with 237 cases of severe neonatal enterovirus infection were included. All neonates developed severe complications. Among them, 46.0% neonates had hepatitis or coagulopathy, 37.1% had myocarditis, 11.0% had meningoencephalitis, and 5.9% had other complications such as hemophagocytic lymphohistiocytosis and pulmonary hemorrhage. The lethality rate of neonates with severe infection was 30.4%. The highest lethality rate was 38.6%, which was observed in neonates with myocarditis. In 70.5% neonates, the age at the onset of symptoms was less than 7 days. Coxsackievirus B infection was seen in 52.3% neonates. The most common symptoms included temperature abnormalities (127, 53.6%), rash (88, 37.1%), poor feeding (58, 24.5%), and respiratory symptoms (52, 21.9%). The main treatment included transfusion of empirical antibiotics (127, 53.6%), blood components (100, 42.2%), intravenous immunoglobulin (IVIG; 97, 40.9%), mechanical ventilation (51, 21.5%), and extracorporeal membrane oxygenation (ECMO; 43, 18.1%). Additionally, antiviral medications pleconaril (14, 5.9%) and pocapavir (3, 1.3%) were administered.

Conclusions

Lethality was high in neonates with severe enterovirus infection, especially in those complicated with myocarditis. The most common symptoms included temperature abnormalities, rash, and poor feeding. The chief supportive treatment consisted of transfusion of blood components, mechanical ventilation, and ECMO. Empirical antibiotics and IVIG were widely used. Antiviral medications included pocapavir and pleconaril; however, more clinical evidence regarding their efficacy is needed.

Available only for authorised users

CDC. Non-Polio Enterovirus. Available from: www.cdc.gov. Accessed 28 Nov 2020.

Lugo D, Krogstad P. Enteroviruses in the early 21st century: new manifestations and challenges. Curr Opin Pediatr. 2016;28(1):107–13. https://doi.org/10.1097/MOP.0000000000000303.CrossRefPubMedPubMedCentral

Noor A, Krilov LR. Enterovirus infections. Pediatr Rev. 2016;37(12):505–15. https://doi.org/10.1542/pir.2016-0103.CrossRefPubMed

Chuang YY, Huang YC. Enteroviral infection in neonates. J Microbiol Immunol Infect. 2019;52(6):851–7. https://doi.org/10.1016/j.jmii.2019.08.018.CrossRefPubMed

Marodi L. Neonatal innate immunity to infectious agents. Infect Immun. 2006;74(4):1999–2006. https://doi.org/10.1128/IAI.74.4.1999-2006.2006.CrossRefPubMedPubMedCentral

JBI. Critical appraisal tools. Available from: https://jbi.global/critical-appraisal-tools. Accessed 28 Nov 2020.

Le Van Quyen P, Desprez P, Livolsi A, Lindner V, Fafi-Kremer S, Helms P, et al. Peculiar clinical presentation of Coxsackievirus B4 infection: neonatal restrictive cardiomyopathy. Ajp Reports. 2017;7(2):E124–E6.CrossRef

Cantey JB, Hanners N, Mittal V. A persistently fussy, febrile infant. Clin Pediatr (Phila). 2012;51(1):93–5. https://doi.org/10.1177/0009922811400408.CrossRef

Bauer S, Gottesman G, Sirota L, Litmanovitz I, Ashkenazi S, Levi I. Severe Coxsackie virus B infection in preterm newborns treated with pleconaril. Eur J Pediatr. 2002;161(9):491–3. https://doi.org/10.1007/s00431-002-0929-5.CrossRefPubMed

10.

Bersani I, Auriti C, Piersigilli F, Dotta A, Diomedi-Camassei F, Di Pede A, et al. Neonatal acute liver failure due to enteroviruses: a 14 years single NICU experience. J Matern Fetal Neonatal Med. 2020;33(15):2576–80. https://doi.org/10.1080/14767058.2018.1555806.CrossRefPubMed

11.

Torres-Torres S, Myers AL, Klatte JM, Rhoden EE, Oberste MS, Collett MS, McCulloh RJ. First use of investigational antiviral drug pocapavir (v-073) for treating neonatal enteroviral sepsis. Pediatr Infect Dis J. 2015;34(1):52–4. https://doi.org/10.1097/INF.0000000000000497.CrossRefPubMed

12.

Yen MH, Huang YC, Chen MC, Liu CC, Chiu NC, Lien R, Chang LY, Chiu CH, Tsao KC, Lin TY. Effect of intravenous immunoglobulin for neonates with severe enteroviral infections with emphasis on the timing of administration. J Clin Virol. 2015;64:92–6. https://doi.org/10.1016/j.jcv.2015.01.013.CrossRefPubMed

13.

Miyata I, Hanaoka N, Okabe N, Fujimoto T, Sakamoto S, Kasahara M, Saitoh A. Echovirus 3 as another enterovirus causing life-threatening neonatal fulminant hepatitis. J Clin Virol. 2014;59(2):132–4. https://doi.org/10.1016/j.jcv.2013.11.015.CrossRefPubMed

14.

Pedrosa C, Lage MJ, Virella D. Congenital echovirus 21 infection causing fulminant hepatitis in a neonate. BMJ Case Rep. 2013;2013(apr09 1):bcr2012008394. https://doi.org/10.1136/bcr-2012-008394.CrossRefPubMedPubMedCentral

15.

Pino-Ramirez RM, Pertierra-Cortada A, Iriondo-Sanz M, Krauel-Vidal X, Munoz-Almagro C. Neonatal echovirus 30 infection associated with severe hepatitis in twin neonates. Pediatr Infect Dis J. 2008;27(1):88. https://doi.org/10.1097/INF.0b013e31815b395b.CrossRefPubMed

16.

Ling LC, Pak CN, Chan PKS, Hiu LW, Cheng FWT, Tang JWT. Probable intrafamilial transmission of coxsackievirus B3 with vertical transmission, severe early-onset neonatal hepatitis, and prolonged viral RNA shedding. Pediatrics. 2006;118(3):e929–e33.CrossRef

17.

Tancabelic J, Haun SE. Management of coagulopathy with recombinant factor VIIa in a neonate with echovirus type 7. Pediatric Blood Cancer. 2004;43(2):170–6. https://doi.org/10.1002/pbc.20078.CrossRefPubMed

18.

Wallot MA, Metzger-Boddien C, Auth M, Kehle J, Enders G, Dirsch O, Fiedler M, Voit T. Acute liver failure associated with Coxsackie virus B2 infection in a neonate. Eur J Pediatr. 2004;163(2):116–7. https://doi.org/10.1007/s00431-003-1377-6.CrossRefPubMed

19.

Yen HR, Lien R, Fu RH, Chang LY. Hepatic failure in a newborn with maternal peripartum exposure to echovirus 6 and enterovirus 71. Eur J Pediatr. 2003;162(9):648–9. https://doi.org/10.1007/s00431-003-1269-9.CrossRefPubMed

20.

Abzug MJ. Prognosis for neonates with enterovirus hepatitis and coagulopathy. Pediatr Infect Dis J. 2001;20(8):758–63. https://doi.org/10.1097/00006454-200108000-00008.CrossRefPubMed

21.

Aradottir E, Alonso EM, Shulman ST. Severe neonatal enteroviral hepatitis treated with pleconaril. Pediatr Infect Dis J. 2001;20(4):457–9. https://doi.org/10.1097/00006454-200104000-00022.CrossRefPubMed

22.

Ventura KC, Hawkins H, Smith MB, Walker DH. Fatal neonatal echovirus 6 infection: autopsy case report and review of the literature. Modern Pathol. 2001;14(2):85–90. https://doi.org/10.1038/modpathol.3880260.CrossRef

23.

Wang J, Atchison RW, Walpusk J, Jaffe R. Echovirus hepatic failure in infancy: report of four cases with speculation on the pathogenesis. Pediatr Dev Pathol. 2001;4(5):454–60. https://doi.org/10.1007/s10024001-0043-0.CrossRefPubMed

24.

Konen O, Rathaus V, Bauer S, Dolfin T, Shapiro M. Progressive liver calcifications in neonatal coxsackievirus infection. Pediatr Radiol. 2000;30(5):343–5. https://doi.org/10.1007/s002470050755.CrossRefPubMed

25.

Weickmann J, Gebauer RA, Paech C. Junctional ectopic tachycardia in neonatal enterovirus myocarditis. Clin Case Rep. 2020;8(6):987–90. https://doi.org/10.1002/ccr3.2796.CrossRefPubMedPubMedCentral

26.

Lee SR, Ko SY, Yoon SY, Lee YK, Shin SM. Early detection and successful treatment of vertically transmitted fulminant enteroviral infection associated with various forms of arrhythmia and severe hepatitis with coagulopathy. Pediatric Infect Vaccine. 2019;26(3):199–205. https://doi.org/10.14776/piv.2019.26.e16.CrossRef

27.

Amdani SM, Kim HS, Orvedahl A, John AO, Said A, Simpson K. Successful treatment of fulminant neonatal enteroviral myocarditis in monochorionic diamniotic twins with cardiopulmonary support, intravenous immunoglobulin and pocapavir. BMJ Case Rep. 2018;2018:bcr2017224133. https://doi.org/10.1136/bcr-2017-224133.

28.

Cortina G, Best D, Deisenberg M, Chiletti R, Butt W. Extracorporeal membrane oxygenation for neonatal collapse caused by enterovirus myocarditis. Arch Dis Child Fetal Neonatal Ed. 2018;103(4):F370–f6. https://doi.org/10.1136/archdischild-2016-312429.CrossRefPubMed

29.

McGovern E, Ryan E, McMahon CJ. An infant with out-of-hospital cardiac arrest secondary to enteroviral myocarditis surviving up to cardiac transplantation. Cardiol Young. 2016;26(1):158–60. https://doi.org/10.1017/S1047951114002595.CrossRefPubMed

30.

Morriss FH Jr, Lindower JB, Bartlett HL, Atkins DL, Kim JO, Klein JM, et al. Neonatal Enterovirus infection: case series of clinical Sepsis and positive cerebrospinal fluid polymerase chain reaction test with myocarditis and cerebral white matter injury complications. AJP Rep. 2016;6(3):e344–e51. https://doi.org/10.1055/s-0036-1593406.CrossRefPubMedPubMedCentral

31.

Bae EY, Lee EJ, Han SB, Lee JY, Jeong DC, Kang JH. A case of myocarditis following neonatal meningitis caused by coxsackievirus B1 in spite of intravenous immunoglobulin treatment. J Trop Pediatr. 2014;60(2):164–7. https://doi.org/10.1093/tropej/fmt086.CrossRefPubMed

32.

Bissel SJ, Winkler CC, DelTondo J, Wang G, Williams K, Wiley CA. Coxsackievirus B4 myocarditis and meningoencephalitis in newborn twins. Neuropathology. 2014;34(5):429–37. https://doi.org/10.1111/neup.12121.CrossRefPubMedPubMedCentral

33.

Bonnin A, Tassin M, Vauloup-Fellous C, Letamendia E, Stos B, Bonnet D, Gajdos V, Mabille M, Benachi A. Case of a healthy infant born following antenatal enterovirus myocarditis and hydrops. J Clin Virol. 2014;61(3):459–62. https://doi.org/10.1016/j.jcv.2014.08.028.CrossRefPubMed

34.

Elisha N, Paret G, Rubinsthein M, Salem I. Enteroviral myocarditis requiring extracorporeal membranous oxygenation in a 2 week old girl. Israel Med Assoc J. 2013;15(6):319–20.

35.

Schlapbach LJ, Ersch J, Balmer C, Pretre R, Tomaske M, Caduff R, et al. Enteroviral myocarditis in neonates. J Paediatr Child Health. 2013;49(9):E451–E4. https://doi.org/10.1111/jpc.12248.CrossRefPubMed

36.

Kobayashi D, Pettersen MD, Walters HL 3rd, Aggarwal S. Mitral valve surgery for severe mitral regurgitation and dilated cardiomyopathy--a bridge to transplant: case report and a review of literature. Congenit Heart Dis. 2012;7(5):E39–65. https://doi.org/10.1111/j.1747-0803.2011.00626.x.CrossRefPubMed

37.

Madden K, Thiagarajan RR, Rycus PT, Rajagopal SK. Survival of neonates with enteroviral myocarditis requiring extracorporeal membrane oxygenation. Pediatric Crit Care Med. 2011;12(3):314–8. https://doi.org/10.1097/PCC.0b013e3181e8b44b.CrossRef

38.

Takahashi H, Tsukamoto K, Takahashi S, Nakamura T, Ito Y, Kaneko M, Sago H. Reversible Atrioventricular block and Junctional ectopic tachycardia in Coxsackievirus B3-induced fetal-neonatal myocarditis without left ventricular dysfunction. AJP Rep. 2011;1(1):37–42. https://doi.org/10.1055/s-0031-1277102.CrossRefPubMedPubMedCentral

39.

Freund MW, Kleinveld G, Krediet TG, van Loon AM, Verboon-Maciolek MA. Prognosis for neonates with enterovirus myocarditis. Arch Dis Child Fetal Neonatal Ed. 2010;95(3):F206–12. https://doi.org/10.1136/adc.2009.165183.CrossRefPubMed

40.

Al Senaidi K, Lacson A, Rebeyka IM, Mackie AS. Echocardiographic detection of early myocardial calcification in acute neonatal myocarditis due to Coxsackie virus type B. Pediatr Cardiol. 2009;30(6):862–3. https://doi.org/10.1007/s00246-009-9443-0.CrossRefPubMed

41.

Meyer S, Gortner L, Gottschling S, Gartner B, Abdul-Khaliq H. Cardiogenic shock in a neonate with enterovirus myocarditis. Klinische Padiatrie. 2009;221(7):444–7. https://doi.org/10.1055/s-0029-1231075.CrossRefPubMed

42.

Simpson KE, Hulse E, Carlson K. Atrial tachyarrhythmias in neonatal enterovirus myocarditis. Pediatr Cardiol. 2009;30(6):827–30. https://doi.org/10.1007/s00246-009-9398-1.CrossRefPubMed

43.

Verma NA, Zheng XT, Harris MU, Cadichon SB, Melin-Aldana H, Khetsuriani N, Oberste MS, Shulman ST. Outbreak of life-threatening coxsackievirus B1 myocarditis in neonates. Clin Infect Dis. 2009;49(5):759–63. https://doi.org/10.1086/605089.CrossRefPubMed

44.

Krogstad P, Hammon R, Halnon N, Whitton JL. Fatal neonatal myocarditis caused by a recombinant human enterovirus-b variant. Pediatr Infect Dis J. 2008;27(7):668–9. https://doi.org/10.1097/INF.0b013e31816b5d2a.CrossRefPubMed

45.

Nathan M, Walsh R, Hardin JT, Einzig S, Connor BO, Balaguru D, Verma R, Starr JP Enteroviral sepsis and ischemic cardiomyopathy in a neonate: case report and review of literature. ASAIO J 2008;54(5):554–5, 555, DOI: https://doi.org/10.1097/MAT.0b013e3181877fc5.

46.

Simmonds J, Cubitt D, Ashworth M, Burch M. Successful heart transplantation following neonatal necrotic enterovirus myocarditis. Pediatr Cardiol. 2008;29(4):834–7. https://doi.org/10.1007/s00246-007-9182-z.CrossRefPubMed

47.

Smets K, Keymeulen A, Wollants E, Lagrou K, Van Ranst M, Padalko E. Detection of enteroviral RNA on Guthrie card dried blood of a neonate with fatal Coxsackie B3 myocarditis on day 17. J Clin Virol. 2008;42(2):207–10. https://doi.org/10.1016/j.jcv.2008.01.004.CrossRefPubMed

48.

Lu JC, Koay KW, Ramers CB, Milazzo AS. Neonate with coxsackie B1 infection, cardiomyopathy and arrhythmias. J Natl Med Assoc. 2005;97(7):1028–30.PubMedPubMedCentral

49.

Inwald D, Franklin O, Cubitt D, Peters M, Goldman A, Burch M. Enterovirus myocarditis as a cause of neonatal collapse. Arch Dis Child Fetal Neonatal Ed. 2004;89(5):F461–F2. https://doi.org/10.1136/adc.2003.034439.CrossRefPubMedPubMedCentral

50.

Ouellet A, Sherlock R, Toye B, Fung KF. Antenatal diagnosis of intrauterine infection with coxsackievirus B3 associated with live birth. Infect Dis Obstet Gynecol. 2004;12(1):23–6. https://doi.org/10.1080/1064744042000210357.CrossRefPubMedPubMedCentral

51.

Bendig JW, Franklin OM, Hebden AK, Backhouse PJ, Clewley JP, Goldman AP, et al. Coxsackievirus B3 sequences in the blood of a neonate with congenital myocarditis, plus serological evidence of maternal infection. J Med Virol. 2003;70(4):606–9. https://doi.org/10.1002/jmv.10437.CrossRefPubMed

52.

Murugan SJ, Gnanapragasam J, Vettukattil J. Acute myocardial infarction in the neonatal period. Cardiol Young. 2002;12(4):411–3. https://doi.org/10.1017/S1047951100013068.CrossRefPubMed

53.

Hoi-shan Chan S, Lun KS. Ventricular aneurysm complicating neonatal coxsackie B4 myocarditis. Pediatr Cardiol. 2001;22(3):247–9. https://doi.org/10.1007/s002460010214.CrossRefPubMed

54.

Oades PJ, Ladhani S. Enteroviral meningoencephalitis in an infant: an increasingly recognised infection. Arch Dis Child. 2015;100(2):208. https://doi.org/10.1136/archdischild-2014-307372.CrossRefPubMed

55.

Guo SJ, Wang DX, Dai CL, Wu H. A neonate with hand, foot, and mouth disease complicated with brainstem encephalitis and pulmonary edema: a complete recovery. Pak J Med Sci. 2014;30(4):917–9. https://doi.org/10.12669/pjms.304.4528.

56.

Ronellenfitsch S, Tabatabai J, Bottcher S, Diedrich S, Frommhold D, Schubert-Bast S, et al. First report of a Chinese strain of coxsackie B3 virus infection in a newborn in Germany in 2011: a case report. J Med Case Rep. 2014;8(1):164. https://doi.org/10.1186/1752-1947-8-164.CrossRefPubMedPubMedCentral

57.

Wu T, Fan XP, Wang WY, Yuan TM. Enterovirus infections are associated with white matter damage in neonates. J Paediatr Child Health. 2014;50(10):817–22. https://doi.org/10.1111/jpc.12656.CrossRefPubMed

58.

Jones G, Muriello M, Patel A, Logan L. Enteroviral Meningoencephalitis complicated by central diabetes Insipidus in a neonate: a case report and review of the literature. J Pediatric Infect Dis Soc. 2015;4(2):155–8. https://doi.org/10.1093/jpids/pit055.CrossRefPubMed

59.

van den Berg-van de Glind GJD, de Vries JJC, Wolthers KC, Wiggers-de Bruine FT, Peeters-Scholte C, van den Hendef M, et al. A fatal course of neonatal meningo-encephalitis. J Clin Virol. 2012;55(2):91–4. https://doi.org/10.1016/j.jcv.2012.05.004.CrossRef

60.

Hirata O, Ishikawa N, Mizoguchi Y, Nakamura K, Kobayashi M. A case of neonatal coxsackie B2 meningo-encephalitis in which serial magnetic resonance imaging findings reveal the development of lesions. Neuropediatrics. 2011;42(4):156–8. https://doi.org/10.1055/s-0031-1285876.CrossRefPubMed

61.

Brecht M, Jyoti R, McGuire W, Chauhan M. A case of neonatal coxsackie B virus brainstem encephalitis. J Paediatr Child Health. 2010;46(11):699–701. https://doi.org/10.1111/j.1440-1754.2010.01907.x.CrossRefPubMed

62.

Verboon-Maciolek MA, Groenendaal F, Cowan F, Govaert P, van Loon AM, de Vries LS. White matter damage in neonatal enterovirus meningoencephalitis. Neurology. 2006;66(8):1267–9. https://doi.org/10.1212/01.wnl.0000208429.69676.23.CrossRefPubMed

63.

Miyoshi Y, Yoshioka S, Gosho H, Miyazoe S, Suenaga H, Aoki M, Hashimoto K. A neonatal case of coxsackievirus B3 vertical infection with symptoms of hemophagocytic lymphohistiocytosis. Idcases. 2020;20:e00738. https://doi.org/10.1016/j.idcr.2020.e00738.CrossRefPubMedPubMedCentral

64.

Watanabe Y, Sugiura T, Sugimoto M, Togawa Y, Kouwaki M, Koyama N, et al. Echovirus Type 7 Virus-Associated Hemophagocytic Syndrome in a Neonate Successfully Treated With Intravenous Immunoglobulin Therapy: A Case Report. Front Pediatrics. 2019;7 (no pagination)469.

65.

Fukazawa M, Hoshina T, Nanishi E, Nishio H, Doi T, Ohga S, Hara T. Neonatal hemophagocytic lymphohistiocytosis associated with a vertical transmission of coxsackievirus B1. J Infect Chemother. 2013;19(6):1210–3. https://doi.org/10.1007/s10156-013-0629-2.CrossRefPubMed

66.

Lindamood KE, Fleck P, Narla A, Vergilio JA, Degar BA, Baldwin M, Wintermark P. Neonatal enteroviral sepsis/meningoencephalitis and hemophagocytic lymphohistiocytosis: diagnostic challenges. Am J Perinatol. 2011;28(5):337–46. https://doi.org/10.1055/s-0030-1268710.CrossRefPubMed

67.

Orbach R, Mandel D, Lubetzky R, Ovental A, Haham A, Halutz O, Grisaru-Soen G. Pulmonary hemorrhage due to Coxsackievirus B infection-a call to raise suspicion of this important complication as an end-stage of enterovirus sepsis in preterm twin neonates. J Clin Virol. 2016;82:41–5. https://doi.org/10.1016/j.jcv.2016.07.003.CrossRefPubMed

68.

Tassin M, Martinovic J, Mirand A, Peigue-Lafeuille H, Picone O, Benachi A, Vauloup-Fellous C. A case of congenital echovirus 11 infection acquired early in pregnancy. J Clin Virol. 2014;59(1):71–3. https://doi.org/10.1016/j.jcv.2013.11.003.CrossRefPubMed

69.

Willems A, Benne CA, Timmer A, Bergman KA. Fatal illness associated with pulmonary hypertension in a neonate caused by intrauterine echovirus 11 infection. Am J Perinatol. 2006;23(1):59–61. https://doi.org/10.1055/s-2005-918890.CrossRefPubMed

70.

Tarcan A, Ozbek N, Gurakan B. Bone marrow failure with concurrent enteroviral infection in a newborn. Pediatr Infect Dis J. 2001;20(7):719–21. https://doi.org/10.1097/00006454-200107000-00019.CrossRefPubMed

71.

Sauerbrei A, Gluck B, Jung K, Bittrich H, Wutzler P. Congenital skin lesions caused by intrauterine infection with coxsackievirus B3. Infection. 2000;28(5):326–8. https://doi.org/10.1007/s150100070029.CrossRefPubMed

72.

Lv XQ, Qian LH, Wu T, Yuan TM. Enterovirus infection in febrile neonates: a hospital-based prospective cohort study. J Paediatr Child Health. 2016;52(8):837–41. https://doi.org/10.1111/jpc.13193.CrossRefPubMed

73.

Xu S, Li H, Qiao P, Xu G, Zhao D, Lin X, Qin Y, Yu H, Zhang X, Zhang W, Huang L. Neonatal hand, foot, and mouth disease due to coxsackievirus A6 in Shanghai. BMC Pediatr. 2020;20(1):364. https://doi.org/10.1186/s12887-020-02262-y.CrossRefPubMedPubMedCentral

74.

Yen MH, Tsao KC, Huang YC, Huang CG, Huang YL, Lin R, Chang ML, Huang CC, Yan DC, Lin TY. Viral load in blood is correlated with disease severity of neonatal coxsackievirus B3 infection: early diagnosis and predicting disease severity is possible in severe neonatal enterovirus infection. Clin Infect Dis. 2007;44(10):e78–81. https://doi.org/10.1086/515399.CrossRefPubMed

75.

Abzug MJ, Michaels MG, Wald E, Jacobs RF, Romero JR, Sanchez PJ, et al. A randomized, double-blind, placebo-controlled trial of Pleconaril for the treatment of neonates with Enterovirus Sepsis. J Pediatric Infect Dis Soc. 2016;5(1):53–62. https://doi.org/10.1093/jpids/piv015.CrossRefPubMed

Title: Clinical characteristics of severe neonatal enterovirus infection: a systematic review
Authors: Meng Zhang
Haoran Wang
Jun Tang
Yang He
Tao Xiong
Wenxing Li
Yi Qu
Dezhi Mu
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Coxsackievirus
Meningoencephalitis
Disseminated Intravascular Coagulation
Myocarditis
Hepatitis
Hemophagocytic Lymphohistiocytosis
ECMO
ECMO
Hemophagocytic Lymphohistiocytosis
Published in: BMC Pediatrics / Issue 1/2021
Electronic ISSN: 1471-2431
DOI: https://doi.org/10.1186/s12887-021-02599-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical characteristics of severe neonatal enterovirus infection: a systematic review

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Bedside upper gastrointestinal series in the neonatal intensive care unit

Superabsorbent polymer balls as foreign bodies in the nasal cavities of children: our clinical experience

Serum HMGB1 level is correlated with serum I-FABP level in neonatal patients with necrotizing enterocolitis

Interaction between antibiotic use and MS4A2 gene polymorphism on childhood eczema: a prospective birth cohort study

Nutritional status of school children living in Northern part of Sri Lanka

A rare case of fetus in fetu in the sacrococcygeal region: CT and MRI findings