Introduction Enterovirus infections are frequent in childhood. Especially in the neonatal period these can cause severe neonatal infections. Transmission either occurs vertically or nosocomially. Breast milk as a possible source of vertical infection has only been described in a single case.
History We report the case of a preterm infant of 32 weeks of gestation delivered by caesarean section due to severe maternal enterovirus infection.
Pregnancy was unremarkable until 31 5/7 weeks of gestation, when the mother suffered from meningitis and was admitted to the prenatal ward. Due to clinical deterioration a caesarean section was performed. Maternal CSF as well as anal swab contained echovirus type 30.
Clinical Course Within the first days after birth the neonate developed clinical signs of infection (CRP 1.5 mg/dl, platelets 18.000/µl). Antibiotic therapy was initiated and the patient´s condition slowly improved.
Neonatal virus PCR’s from nasopharynx and rectum yielded echovirus type 30. Additionally breast milk was tested and a copy number of more than 8 million copies per ml was quantified. At that stage we detected only a moderate amount of Enterovirus in the maternal anal swab while the maternal oral swab had already turned negative again.
Conclusion Enterovirus infections in neonates are more frequent than previously recognised. Transmission by breast feeding according to the viral load in the breast milk is more than likely.