ABSTRACT 584

Abstract

Background and aims: Although maternal infections with Coxsackie virus during pregnancy are relatively common, fetal infections are quite rare. Coxsackie virus infection in utero has been associated with fetal loss, myocarditis and increased incidence of congenital anomalies. Aims: To present a rare case of congenital Coxsackie B2 virus infection. Methods: A clinical case of a preterm girl diagnosed with bilateral pleural effusions by a routine ultrasonography at 28 weeks of gestational age. The ultrasonographic follow up of the pregnancy detected a marked increase in the pleural effusions and fetal distress. Results: The infant was delivered by an emergency cesarean section in 29 gestational weeks with initial Apgar score 5 at 1st minute and birth weight – 1900 g. A bilateral pleural punction was performed before the umbilical cord clamping. On admission to NICU, respiratory insufficiency required intubation, positive pressure ventilation and surfactant therapy. The initial chest radiograph showed total right pneumothorax and small residual effusion on the left. A bilateral thoracocentesis (Seldinger`s technique) was performed and permanent thoracic suction was turned on. Pleural fluid analysis was not helpful in determining the etiology of the effusions. A serological test (ELISA) of the newborn serum showed high titer of Coxsackie B2 virus. The patient was discharged from the NICU at 37th gestational week without any signs of respiratory distress and normal for age neurological development. Conclusions: This rare case presents the importance of the multidisciplinary approach in the early diagnostic evaluation and intensive care treatment of high-risk neonates for achieving a successful outcome.