Table 2 Clinical features of neonates severe enteroviral infections of rare complications (%)
From: Clinical characteristics of severe neonatal enterovirus infection: a systematic review
| Â | Hemophagocytic lymphohistiocytosis | Â | Â | Â | Â | |||
Reference | Miyoshi, 2020 | Fukazawa, 2013 | Watanabe, 2019 | Lindamood, 2011 | Â | Â | ||
Country | Japan | Japan | Italy | Canada | Â | Â | ||
Sex | Female | Male | Male | Male | Male | Female | ||
GA (weeks) | 38 | 35 | 37 | 37 | 38 | 41 | ||
BW (g) | 2860 | 2260 | NA | 4010 | 3550 | 3120 | ||
Mode of delivery | Vaginal | Caesarean | NA | Caesarean | Vaginal | Caesarean | ||
Maternal manifestation, days onset before delivery | Fever, 0 | Abdominal pain, 1; Fever, 0 | Fever, 0 | Flu-like illness, 0 | NA | Flulike illness, 2 weeks | ||
Days at onset | 3 | 4 | 4 | 3 | 5 | 0 | ||
Virus isolation (serotype) | Blood, NPS, stool, urine (CVB3) | NPS, stool (CVB1) | CSF, pharyngeal fluid, stool, urine (Echovirus 7) | Blood | Blood | Blood, CSF | ||
Clinical signs | Apnea, fever, petechiae, poor feeding, thrombocytopenia | Apnea, hepatosplenomegaly, thrombocytopenia | Apnea, lethargy | Bleeding, fever, hepatosplenomegaly, thrombocytopenia | Cyanosis, hemodynamic instability, respiratory distress, thrombocytopenia | Lethargy, petechiae, splenomegaly, thrombocytopenia | ||
Other manifestation | Coagulopathy, liver dysfunction | Coagulopathy | DIC | Coagulopathy, liver failure | Coagulopathy | Coagulopathy, meningoencephalitis | ||
Auxiliary examination findings | Hyperferritinemia | Leukocytosis | Elevated LDH, AST, ferritin levels | Anemia | Anemia, elevated ferritin level | Elevated ferritin level | ||
Treatment | Blood component transfusions, IVIG | Blood transfusions, recombinant thrombomodulin, IVIG | Blood component transfusions, mechanical ventilation, thrombomodulin, antibiotics, IVIG | Blood component transfusions, cryoprecipitate, IVIG, liver transplantation at 2 months of age | Blood component transfusions, continuous venovenous hemofiltration, cryoprecipitate, mechanical ventilation | Blood component transfusions, cryoprecipitate, IVIG | ||
Outcome, last follow-up | Survived, 25 days | Survived, 11 months | Survived, 18 months | Survived, 2.5 years | Died, 14 days | Survived, 2 weeks | ||
| Â | Pulmonary hemorrhage | Â | Â | Â | Bone marrow failure | Congenital Skin Lesions | Pulmonary hypoplasia | Persistent pulmonary hypertension |
Reference | Orbach, 2016 | Â | Â | Â | Tarcan, 2001 | Sauerbrei, 2000 | Tassin, 2014 | Willems, 2006 |
Country | Israel | Â | Â | Â | Turkey | America | France | Belgium |
sex | NA (2 twins) | NA | NA | NA | Male | Male | NA | Female |
GA (weeks) | 30 | 30 | 36 | 36 | 40 | 39 | 38 | 36 |
BW (g) | NA | NA | NA | NA | 3800 | NA | NA | 2810 |
Mode of delivery | Caesarean | Caesarean | Vaginal | Vaginal | Caesarean | Vaginal | Vaginal | Caesarean |
Maternal manifestation, days onset before delivery | Abdominal pain, seizures and fever, 0 | Abdominal pain, seizures and fever, 0 | Fever, a few hours | Fever, a few hours | Diarrhea and fever, 2 weeks | Mild signs of respiratory infections, 2 weeks | Spontaneous demise of a co-twin, 14 gestational weeks | Abdominal pain and fever |
Days at onset | 7 | 7 | 5 | 5 | 5 | 0 | 0 | 0 |
Virus isolation (serotype) | CSF (CVB3) | CSF (CVB3) | Brain, liver, lung, stool (CVB2) | CSF, stool (CVB2) | Stool (Echovirus 11) | Serum (CVB3) | Amniotic fluid, lung (Echovirus 11) | Intestine, lung, stool, tracheal aspirate (Echovirus 11) |
Clinical signs | Cutis marmorata, poor response, thrombocytopenia | Cutis marmorata, hemodynamic instability, tachycardia, respiratory distress, thrombocytopenia | Cutis marmorata, fever, poor perfusion, thrombocytopenia | Fever | Diarrhea, fever, hepatosplenomegaly, petechiae, rash | Atopic dermatitis with Candida infection, bronchopulmonal dysplasia, impaired central coordination, papulovesicular, nodular, bullous and ulcerative rash | 32 WG a bilateral abnormal lung development | Respiratory distress, purpura |
Other manifestation | DIC, intraventricular hemorrhage | DIC | NA | NA | Transient pancytopenia concurrent | Hepatitis, myocarditis, pneumonia | NA | DIC, meningitis, pneumonia |
Auxiliary examination findings | Acidosis, elevated transaminase, leukopenia | Leukopenic | NA | NA | Bone marrow aspiration and biopsy: hypocellularity | NA | Ultrasound and MRI: bilateral abnormal lung development | NA |
Treatment | Antibiotics, IVIG | Mechanical ventilation, antibiotics, IVIG | Antibiotics | Antibiotics | Antibiotics, IVIG | Mechanical ventilation, antibiotics | Adrenaline, mechanical ventilation | Inhaled nitric oxide, prostacyclin infusion, antibiotics, surfactant |
Outcome, last follow-up | Died, 8 days | Died, 12 days | Died, 8 days | Survived | Survived | Survived | Died, 1 h | Died, 36 h |