Nonpolio enterovirus infection in the neonate and young infant

Abstract

Nonpolio enterovirus infections are common in the neonatal period, accounting for a large portion of febrile illness during the summer months. Unlike older children and adults, some neonates with enterovirus infection progress to multisystem disease and death. Multiple clinical syndromes of varying severity are associated with neonatal enterovirus infection: asymptomatic viral shedding, nonspecific febrile illness, aseptic meningitis, hepatic necrosis and coagulopathy, and myocarditis. In the present paper, a typical case of neonatal febrile illness is presented and the English-language literature is reviewed with respect to enteroviral infection in early infancy. The virology, epidemiology, transmission, clinical features, diagnosis and treatment of neonatal enteroviral infection are presented. Although the majority of infections in the neonate are benign, timely diagnosis in the febrile neonate will expedite efficient management. Clinicians also need to recognize the clinical manifestations and risk factors for severe disease to anticipate complications and implement intensive management of infants at high risk of adverse outcomes.