Congenital echovirus 21 infection causing fulminant hepatitis in a neonate

Cristina Pedrosa

Maria Lage

Daniel Virella

Neonatal Intensive Care Unit, Hospital de Dona Estefânia, Lisbon, Portugal

^{Dr Cristina Pedrosa,}moc.liamg@sirc.asordep

Neonatal Intensive Care Unit, Hospital de Dona Estefânia, Lisbon, Portugal

^{Dr Cristina Pedrosa,}moc.liamg@sirc.asordep

Abstract

Enteroviral infection in pregnancy is common and there is growing evidence relating it to congenital anomalies and neonatal mortality. Neonatal disease may range from unapparent infection to overwhelming systemic illness. Passively acquired maternal serotype specific antibodies determine the severity of the disease in the newborn. A fatal case of congenital echovirus 21 infection, confirmed by PCR in the patient's blood and positive culture of the mother's stools, is reported. A sibling had symptoms of respiratory tract infection and their mother had fever, which prompted iatrogenic delivery that same day. The newborn presented with bradycardia and hypotonia in the first minutes of life and later developed respiratory distress, disseminated intravascular coagulopathy, fulminant hepatitis, acute renal failure and necrotising enterocolitis. Death occurred on the 8 day of life. This case highlights the potential severity of Enteroviral infection in the newborn. Since only supportive treatment is available, prevention is paramount.

Abstract

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Footnotes

Competing interests: None.

Patient consent: Obtained.

Provenance and peer review: Not commissioned; externally peer reviewed.

Footnotes

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