Enterovirus infections are common in the neonatal period. Newborns are at a higher risk of severe disease including
meningoencephalitis,
sepsis syndrome, cardiovascular collapse, or
hepatitis. The mechanism of
heart failure in patients with
enterovirus infection remains unknown. Early diagnosis may help clinicians predict complications in those infants initially presenting with severe disease. An 11-day-old male newborn was admitted to our neonatal intensive care unit because of
tachycardia and crises of
cyanosis. His elder brother had febrile illness. The newborn was cyanotic, in respiratory distress, with
tachycardia,
low blood pressure and prolonged capillary refilling time. Limb pulse oximeter was around 85%. During the first day of hospitalization, the newborn had one febrile episode. Laboratory data: elevated
transaminases, markers of
inflammation negative, all bacterial cultures negative. Enterovirus
RNA was detected in blood sample. Other blood findings were without significant abnormalities. Electrocardiogram showed
tachycardia, with narrow QRS complexes (atrial
tachycardia) and heart rate up to 280/min. In order to convert the rhythm, the patient was administered
adenosine and
amiodarone. In the further course of hospitalization, the patient was in good general condition, eucardiac and eupneic. Newborns with
tachycardia and a family history of febrile illness should be suspected to have
enterovirus infection.
Enterovirus infection is a highly contagious and potentially life-threatening
infection if not detected early. The use of sensitive molecular-based amplification methods offers potential benefits for early diagnosis and timely treatment.