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Case Reports
. 2023 Sep 6:11:1181698.
doi: 10.3389/fped.2023.1181698. eCollection 2023.

Severe neonatal enterovirus infection in twins with different outcomes: A case report

Kelly K Storm #  1   2 , Daan De Herdt #  1   3 , Karen Couderé  4 , Jaco J Verweij  4 ; VIRO-TypeNed; Leo Torn  1 , Tim Hundscheid  5 , Herbert M van Wering  1
Affiliations
Case Reports

Severe neonatal enterovirus infection in twins with different outcomes: A case report

Kelly K Storm et al. Front Pediatr. .

Abstract

Enteroviruses are among the most common causes of acute viral illness worldwide, and in neonates, the clinical course of these infections is heterogeneous. Severe complications, such as myocarditis, are associated with high mortality rates. In this case report, we present the clinical course of premature twins born at 35 weeks of gestational age, suffering from a severe neonatal enterovirus infection with cardiac involvement, which proved fatal in one of the twins. This course led to prompt identification in the other twin and facilitated timely transfer to a neonatal intensive care unit with neonatal hemodynamic expertise, and facilitated the timely transfer to a neonatal intensive care nit with hemodynamic expertise and immediate availability of AZCMO would it have been indicated. Early supportive therapy in the other twin contributed to a positive outcome. Therefore, we emphasize the importance of early recognition in averting adverse consequences. As a recommendation, we propose routine screening of enterovirus in viral panels for febrile newborns.

Keywords: ECMO; enterovirus; myocarditis; neonatology; sepsis; twins.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Overview of (positively) tested samples on enterovirus for each twin. Cardiac and lung biopsies were obtained during postmortem examination.
Figure 2
Figure 2
Course of cardiac biomarkers NT-proBNP and troponin T in twin B.
Figure 3
Figure 3
Occurrence of CVB1 in the Netherlands. The figure gives the absolute number of CVB1 infections (bars) and proportion of CVB1 of total EV infections (line) between 2010 and 2022.
See this image and copyright information in PMC

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