Article Text
Abstract
Background Recent studies suggest a synergic effect of infection and hypoxia-ischemia in the causation of perinatal brain damage. Although an infection screening is warranted in cases of hypoxic-ischaemic encephalopathy (HIE), whether this screening should include more infrequent pathogens like neurotropic viruses is controversial.
Objectives To evaluate the importance of perinatal infection in HIE, focusing on neurotropic viruses.
Methods Prospective study including infants above 35 weeks gestation diagnosed of moderate or severe HIE in Burgos University Hospital during the period October 2011–2013. Antenatal and perinatal data were recorded, as well as details of the clinical course in the neonatal period. Serological studies were performed to the mother during pregnancy. Bacterial blood and cerebrospinal cultures, as well as viral tests (Cytomegalovirus, Epstein-Barr virus, Human Herpes virus, Enterovirus, Parechovirus) in cerebrospinal fluid were performed to the newborns at birth.
Results 12 newborns were included in the study. There were no confirmed cases of viral infection. There was a case of bacterial early onset sepsis and three cases of suspected sepsis due to clinical and/or analytical signs, but with negative cultures. An elevation of the C reactive protein (CRP) levels was the sole cause of suspicion in two of these cases.
Conclusions Our results confirm that an infection screening is important in HIE. These pilot results would not support universal screening for viral infection in cases of HIE.