Enteroviruses are common human viruses associated with various clinical syndromes, from minor febrile illness to severe, potentially fatal conditions (e.g., aseptic meningitis, paralysis, myocarditis, and neonatal enteroviral sepsis). Neonates are at higher risk for severe illness because of the immaturity of their immune system. Neonatal systemic enterovirus disease is characterized by multiorgan involvement. Typical clinical presentations include encephalomyocarditis (characteristic of group B coxsackieviruses) and haemorrhage-hepatitis syndrome (typical of echovirus 11). EV are important neonatal pathogens associated with a high risk of infection and death. Therefore, EV infections must be considered in the differential diagnosis of early and late neonatal sepsis. In the paper, the authors present three neonates with variable clinical courses, two with early “sepsis-like” syndrome and one with late „sepsis-like syndrome“ and aseptic meningitis. It is important to consider enteroviral infections in the differential diagnosis of neonatal sepsis, especially if, as in our cases, the poor clinical condition of the infants does not correspond to only a mild increase in acute phase reactants or if the LP findings suggest aseptic meningitis

Darjan Kardum, darjan_kardum@yahoo.com
Neonatal Intensive Care Unit, Department of Paediatrics, University Hospital Osijek,
J. Huttlera 4, 31000 Osijek, Croatia

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