Enteroviruses (EVs) are major pathogens in young infants. These viruses were traditionally classified into the following four subgenera: polio, coxsackie A and B, and echoviruses. Now that poliomyelitis seems to be controlled in most parts of the world, coxsackie and echoviruses are gaining more attention because (i) the structural and pathophysiological similarities and (ii) the consequent possibilities in translational medicine. Enteroviruses are transmitted mainly by oral and fecal-oral routes; the clinical manifestations include a viral prodrome including fever, feeding intolerance, and lethargy, which may be followed by exanthema; aseptic meningitis and encephalitis; pleurodynia; myopericarditis; and multi-system organ failure. Laboratory diagnosis is largely based on reverse transcriptase-polymerase chain reaction, cell culture, and serology. Prevention and treatment can be achieved using vaccination, and administration of immunoglobulins and antiviral drugs. In this article, we have reviewed the properties of these viruses, their clinical manifestations, and currently available methods of detection, treatment, and prognosis.

Idiopathic infantile arterial calcification is a rare cause of infantile ischemic cardiac failure with extremely poor prognosis. We present the first case report of successful extracorporeal membrane oxygenation support and outcome in a child with idiopathic infantile arterial calcification (IIAC). This 6-week-old infant presented with cardiogenic shock and circulatory collapse. The patient underwent extracorporeal cardiopulmonary resuscitation, allowing stabilization, diagnosis, and treatment with etidronate, followed by successful discharge to home.

Varicella-zoster virus (VZV) is a human pathogen of the α-herpesvirus family. Some fetuses infected in utero around 8-20 weeks of pregnancy show signs of congenital varicella syndrome (CVS). Infants born to mothers who develop varicella within 5 days before and 2 days after delivery can experience severe disease with increased mortality. The best diagnostic modality is polymerase chain reaction (PCR), which can be done using vesicular swabs or scrapings, scabs from crusted lesions, tissue from biopsy samples, and cerebrospinal fluid. The prevention and management of varicella infections include vaccination, anti-VZV immunoglobulin, and specific antiviral drugs. In this article, we have reviewed the characteristics of VZV, clinical manifestations, management of perinatal infections, and short-and long-term prognosis.

Structure: Chikungunya virus (CHIKV) is an arthropod-borne ribonucleic acid (RNA) virus, classified in the genus alphavirus in the family Togaviridae. Clinical presentation: Perinatal/neonatal infections are rare, but some infants can develop fever, thrombocytopenia, lymphopenia, pigmentary changes, and a maculopapular rash. The neurocognitive outcome of some infants with vertically transmitted mother-to-child perinatal infections and CHIKV neonatal encephalopathy can be poor. Diagnosis:The diagnosis of CHIKV infections can be confirmed by the detection of chikungunya viral RNA via real-time reverse-transcription polymerase chain reaction (RT-PCR) and/or specific immunoglobulin (Ig)M and IgG serology. Treatment: Currently, no specific antiviral treatment(s) are available for CHIKV, and management is limited to supportive care by maintaining adequate intravascular volume by intravenous fluids and oral rehydration. Infants exposed in utero or during the perinatal period need to be monitored for adverse neurocognitive outcomes.