EC Paediatrics

Introduction: Neonates have immature immune system and are at higher risk for serious complications of bacterial and viral infections, including enteroviral diseases. Evaluating neonates with mild and nonspecific symptoms that are consistent with viral processes can be challenging as it can lead to a wide range of manifestations, from mild febrile illness to severe, potentially fatal sepsis like conditions with multiorgan failure, especially (severe myocarditis and/or hepatitis, often accompanied by encephalitis). Enteroviral disease in neonatal period may be acquired antenatally, intrapartum or postnatally.

Case Presentation: We present a case report of a twin in the first 2 weeks of life with severe encephalitis and systemic enteroviral infection. The diagnosis was confirmed from nasopharyngeal aspirate and blood plasma enterovirus PCR. A maternal infection was highly suspected which can explain that the infection was acquired either prenatal or vertically, more likely at the time of delivery through contact with maternal blood, fecal material, or vaginal or cervical secretions. And, due to the severe illness and the lack of specific antiviral treatment options, the supportive management was provided included ventilation and other medical treatment.

Conclusion: Enteroviral infection is an important differential diagnosis in neonatal encephalitis or severe sepsis like manifestations. Prenatal, intranatal, or early postnatal infection with clinical illness manifested in the first 2 weeks of life is usually associated with an increased risk of severe neonatal illness.

 Keywords: Enteroviral Neonatal Infection; Twin; Congenital Enterovirus Infection

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