Enteroviral Infections in Infants

Abstract

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.

Disseminated Enterovirus Infection in a Patient Affected by Follicular Lymphoma Treated with Obinutuzumab: A Case Report and a Narrative Review of the Literature

“…These viruses replicate in the oropharynx and gastrointestinal (GI) tract and are normally spread by fecal-hand-oral contamination [ 2 ]. The viruses are frequently widely disseminated in the summer and fall during the year, circulating in particular among young children, causing both apparent and inapparent infection [ 3 ]. They can cause nonspecific febrile diseases, sometimes with rash, aseptic meningitis, paralytic disease, pericarditis, and myocarditis, as well as some specific syndromes such as herpangina and hand-foot-and-mouth disease [ 2 , 3 ].…”

“…The viruses are frequently widely disseminated in the summer and fall during the year, circulating in particular among young children, causing both apparent and inapparent infection [ 3 ]. They can cause nonspecific febrile diseases, sometimes with rash, aseptic meningitis, paralytic disease, pericarditis, and myocarditis, as well as some specific syndromes such as herpangina and hand-foot-and-mouth disease [ 2 , 3 ]. There is an overlap in biologic behavior, and the same syndrome can be caused by many different agents [ 2 ].…”

“…There is an overlap in biologic behavior, and the same syndrome can be caused by many different agents [ 2 ]. Antibodies are the main form of defense against EVs, and severe, chronic, and disseminated enteroviral infections are generally limited to neonates or patients with profound B-cell deficiencies [ 3 ]. Within the B-cell deficiencies, we should mention follicular lymphoma (FL) which is a systemic neoplasm of the lymphoid tissue and represents around 5% of all hematological neoplasms and around 20–25% of all new non-Hodgkin lymphoma diagnoses in Western countries [ 4 ], consequently it means that FL is the most common subtype of indolent non-Hodgkin lymphomas.…”

France Reports Rise in Severe Neonatal Infections Caused by a New Enterovirus (Echovirus-11) Variant

“…In the neonatal period, transmission can occur either intrapartum by contact with maternal blood, secretions, or stool or postnatally through intimate contact with infected caretakers. 1,2 The positive-strand RNA virus known as echovirus 11 (E-11) is classified in the genus Enterovirus , family Picornaviridae. In newborns, these infections can lead to life-threatening inflammatory diseases such as acute hepatitis with coagulopathy.…”

“…In France, healthcare facilities that care for neonates should be aware of EV symptoms and be on the lookout for outbreaks of healthcare-associated infections in neonatal wards. 2…”