Infection néonatale précoce à entérovirus: quand faut-il y penser?

Enterovirus (EV) may cause a broad spectrum of clinical syndromes and even cause
a sepsis-like picture. Although they are responsible for high morbidity and
mortality rates, viral testing does not appear in the algorithms for the
evaluation of neonatal infections. During the month of June 2013, we identified 3
cases of EV meningitis in our unit of neonatology. All three infants had fever
during the first week of life and their clinical examination revealed an
irritability. The EV infection was detected by Real-Time Polymerase Chain
Reaction (RT-PCR) EV on the cerebrospinal fluid (CSF). Two of the patients also
had a positive RT-PCR EV in the blood. The 3 newborns were discharged from the
hospital after a few days with no adverse outcome. Our clinical observations and
the literature review suggest that EV infections in neonates ought to be
identified as soon as possible by an early RT-PCR EV on the blood, and on the CSF
if a lumbar puncture is indicated. This could help reduce the administration of
antibiotics and the length of hospital stay.