PROFILE OF ENTEROVIRUS DISEASE IN THE 1ST 2 WEEKS OF LIFE

被引:102
作者
ABZUG, MJ
LEVIN, MJ
ROTBART, HA
机构
[1] UNIV COLORADO,HLTH SCI CTR,DEPT MED,DENVER,CO 80262
[2] UNIV COLORADO,HLTH SCI CTR,DEPT MICROBIOL IMMUNOL,DENVER,CO 80262
[3] UNIV COLORADO,HLTH SCI CTR,DEPT PEDIAT INFECT DIS,DENVER,CO 80262
关键词
ENTEROVIRUS; NEONATE; INFECTION; VIRUS;
D O I
10.1097/00006454-199310000-00005
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
We studied 57 infants less-than-or-equal-to 14 days of age referred for possible enterovirus (EV) infection to assess the accuracy of that clinical diagnosis and describe the natural history of neonatal EV infection. Twenty-nine neonates proved to have EV infection, 23 had illnesses compatible with (but not proven to be) EV infection, and 5 had alternative diagnoses: bacterial infections (2); herpes simplex virus infection (1); and metabolic disorders (2). Neonates with proved EV infection were generally full term and had uncomplicated immediate postnatal periods but high percentages of ill contacts. Neonatal symptoms and signs included fever, irritability, anorexia, lethargy, hypoperfusion, rash, jaundice and respiratory findings. Laboratory abnormalities included cerebrospinal fluid (CSF) pleocytosis, chest radiograph infiltrates, abnormal urinalyses and elevated transaminases. EVs were most commonly isolated from CSF and rectum/stool but also frequently from serum and urine. Five EV-infected patients had severe multisystem disease (pneumonitis, hepatitis, thrombocytopenia, bleeding and meningitis), requiring supportive care and lengthy hospitalizations. All survived, 2 with residual hepatic dysfunction. Markers of severe disease included: early age of illness onset (especially Day 1 of life); maternal viral symptoms at delivery; absence of fever and irritability; tachypnea; lethargy; abdominal distension; hepatomegaly; and positive serum viral culture. These data support conservative management of ill infants less-than-or-equal-to 2 weeks of age and suggest that antiviral therapy for neonatal EV infection would be optimally targeted at infants with early onset illness, multisystem disease and/or viremia.
引用
收藏
页码:820 / 824
页数:5
相关论文
共 18 条
  • [1] DEMONSTRATION OF A BARRIER TO TRANS-PLACENTAL PASSAGE OF MURINE ENTEROVIRUSES IN LATE GESTATION
    ABZUG, MJ
    ROTBART, HA
    LEVIN, MJ
    [J]. JOURNAL OF INFECTIOUS DISEASES, 1989, 159 (04) : 761 - 765
  • [2] EPIDEMIOLOGY AND LABORATORY DIAGNOSIS OF INFECTION WITH VIRAL AND BACTERIAL PATHOGENS IN INFANTS HOSPITALIZED FOR SUSPECTED SEPSIS
    DAGAN, R
    HALL, CB
    POWELL, KR
    MENEGUS, MA
    [J]. JOURNAL OF PEDIATRICS, 1989, 115 (03) : 351 - 356
  • [3] VIREMIA IN HOSPITALIZED CHILDREN WITH ENTEROVIRUS INFECTIONS
    DAGAN, R
    JENISTA, JA
    PRATHER, SL
    POWELL, KR
    MENEGUS, MA
    [J]. JOURNAL OF PEDIATRICS, 1985, 106 (03) : 397 - 401
  • [4] AMBULATORY CARE OF FEBRILE INFANTS YOUNGER THAN 2 MONTHS OF AGE CLASSIFIED AS BEING AT LOW-RISK FOR HAVING SERIOUS BACTERIAL-INFECTIONS
    DAGAN, R
    SOFER, S
    PHILLIP, M
    SHACHAK, E
    [J]. JOURNAL OF PEDIATRICS, 1988, 112 (03) : 355 - 360
  • [5] IDENTIFICATION OF INFANTS UNLIKELY TO HAVE SERIOUS BACTERIAL-INFECTION ALTHOUGH HOSPITALIZED FOR SUSPECTED SEPSIS
    DAGAN, R
    POWELL, KR
    HALL, CB
    MENEGUS, MA
    [J]. JOURNAL OF PEDIATRICS, 1985, 107 (06) : 855 - 860
  • [6] EPIDEMIOLOGY OF NEONATAL ENTEROVIRUS INFECTION
    JENISTA, JA
    POWELL, KR
    MENEGUS, MA
    [J]. JOURNAL OF PEDIATRICS, 1984, 104 (05) : 685 - 690
  • [7] CLEARANCE OF A PERSISTENT HUMAN ENTEROVIRUS INFECTION OF THE MOUSE CENTRAL NERVOUS-SYSTEM BY THE ANTIVIRAL AGENT DISOXARIL
    JUBELT, B
    WILSON, AK
    ROPKA, SL
    GUIDINGER, PL
    MCKINLAY, MA
    [J]. JOURNAL OF INFECTIOUS DISEASES, 1989, 159 (05) : 866 - 871
  • [8] KAPLAN MH, 1983, REV INFECT DIS, V5, P1019
  • [9] RISK-FACTORS ASSOCIATED WITH ECHOVIRUS 11' INFECTION IN A HOSPITAL NURSERY
    KINNEY, JS
    MCCRAY, E
    KAPLAN, JE
    LOW, DE
    HAMMOND, GW
    HARDING, G
    PINSKY, PF
    DAVI, MJ
    KOVNATS, SF
    RIBEN, P
    MARTONE, WJ
    SCHONBERGER, LB
    ANDERSON, LJ
    [J]. PEDIATRIC INFECTIOUS DISEASE JOURNAL, 1986, 5 (02) : 192 - 197
  • [10] ENTEROVIRUS INFECTIONS IN NEONATES
    LAKE, AM
    LAUER, BA
    CLARK, JC
    WESENBERG, RL
    MCINTOSH, K
    [J]. JOURNAL OF PEDIATRICS, 1976, 89 (05) : 787 - 791