Neonatal enterovirus infection can show a septic disease with different organ manifestation and acute heart failure.
2 neonates admitted at the age of 10 and 18 days in cardiogenic shock with respiratory failure, massive lactic acidosis, significantly elevated proBNP and troponin values. Exclusion of congenital heart lesions. No detection of a bacterial infection. No sign of a congenital metabolic disorder. Radiologically significant cardiomegaly and pulmonary oedema. Echocardiography pronounced left ventricular dysfunction and suprasystemic pressures in right ventricle. In one patient, invasive exclusion of coronary pathology. Intensive care treatment with catecholamines and phosphodiesterase inhibitors and mechanical ventilation. Detection of human Coxsackie Virus type B3 in the blood, stool and tracheal secretions of both children. Stabilisation of both children after therapy but in echocardiography persistent left ventricular dysfunction.
Neonatal infection with enteroviruses may present as a decompensated congenital heart defect or neonatal bacterial sepsis clinically. After exclusion of these causes an enterovirus infection is to take into consideration. The prognosis is depending on recovery of cardiac function and other organ functions. In extreme cases, ECMO therapy has to be considered. The duration of the cardiac therapy (beta- blockers, diuretics, ACE inhibitors, etc.) is unclear.