ABSTRACT
BACKGROUND: Enteroviral infections in infants <3 months of age are frequent and under-diagnosed even though they can be life-threatening. Properly conducted subjective examination, which is repeatedly neglected, plays a key role in the diagnosis and treatment of these infections. MATERIALS AND METHODS: Analyses included children <3 months of age with confirmed enterovirus infection, hospitalised in the Department of Paediatrics from January 2019 to February 2020. Infections were confirmed by reverse transcription polymerase chain reaction in the cerebrospinal fluid using Neuro9 FTD set and in the stool using PB-03/Neuro; antibodies were determined in one patient. RESULTS: This study presents a detailed description of three cases with confirmed enterovirus infection and a positive epidemiological history. The cases involve viral sepsis, myocarditis with arrhythmia and circulatory failure, and meningitis with seizures. In addition, the details of 10 patients hospitalised in the Children's Clinic with a confirmed enterovirus infection are presented. Based on these cases, a significant influence of family history-taking on the diagnosis and implementation of appropriate treatment was found. CONCLUSION: In most of the analysed cases, family history of viral infection was positive. In patients with the most severe course of the enterovirus infection, accurate epidemiological history is extremely important, and the suspicion of viral infection and securing appropriate materials for testing may significantly speed up the diagnosis in the newborn and help to implement an appropriate treatment.
Subject(s)
Diagnostic Tests, Routine/methods , Enterovirus Infections/diagnosis , Medical History Taking , Meningitis, Viral/diagnosis , Myocarditis/diagnosis , Neonatal Sepsis/diagnosis , Symptom Assessment/methods , Diagnosis, Differential , Enterovirus Infections/cerebrospinal fluid , Female , Humans , Infant, Newborn , Male , Meningitis, Viral/cerebrospinal fluid , Myocarditis/cerebrospinal fluid , Neonatal Sepsis/cerebrospinal fluid , Poland , Treatment OutcomeABSTRACT
Cardioviruses cause myocarditis and encephalomyelitis in rodents; human cardioviruses have not been ascribed to any disease. We screened 6,854 cerebrospinal fluid and 10 myocardium specimens from children and adults. A genotype 2 cardiovirus was detected from a child who died of sudden infant death syndrome, and 2 untypeable cardioviruses were detected from 2 children with meningitis.
Subject(s)
Cardiovirus Infections/virology , Meningitis, Viral/virology , Sudden Infant Death/cerebrospinal fluid , Adult , Cardiovirus/classification , Cardiovirus/genetics , Cardiovirus/isolation & purification , Cardiovirus Infections/cerebrospinal fluid , Child , Cohort Studies , Communicable Diseases, Emerging/cerebrospinal fluid , Communicable Diseases, Emerging/virology , Germany , Humans , Infant , Meningitis, Viral/cerebrospinal fluid , Myocarditis/cerebrospinal fluid , Myocarditis/virology , Phylogeny , RNA, Viral/cerebrospinal fluid , RNA, Viral/geneticsABSTRACT
CASE PRESENTATION: We report on the case of a 5 year-old girl who developed fulminant myocarditis due to acute infection with influenza virus type B. Cardiac arrest occurred suddenly, resuscitation efforts were not successful, and the patient died of congestive heart failure 24 h after admission to the hospital. DIAGNOSIS: Lymphocytic infiltration of cardiac tissues and virologic studies confirmed the suspected diagnosis of acute viral myocarditis. CONCLUSION: In conclusion, influenza virus type B is one of the infective agents that can cause rapid and fatal myocarditis in previously healthy children. Early cardiac support may be the only option to prevent fatal outcome.