INTRAUTERINE COXSACKIE VIRUS INFECTION
Laina J, Kakourou T, Mostrou G, Matsiota P, Theodoridou M
First Department of Paediatrics, Athens University, Greece
Coxsackie virus infection can be presented in neonates
with meningitis, encephalitis, myocarditis, pneumonia and less common with
hepatitis, coagulopathy and cutaneous eruptions. Studies in animals have
shown Coxsackie virus may also
be involved in the pathogenesis of insulin- dependent diabetes mellitus.
Transmission of
Coxsackie virus to the neonate usually occurs during delivery or in the
perinatal period while a transplacental mode has been proved in a few cases
only. We describe a case of an otherwise normal full-term baby delivered by
cesarean section due to a preceding one, who at delivery presented a
vesiculopapular crusted rash on the face, trunk and extremities.
Coxsackievirus was detected on the 2nd day of life by the
reverse transcriptase polymerase chain reaction (RT-PCR) from the newborn’s
serum and lesion specimen as well as from the mother’s serum. All other
laboratory investigations were normal. New lesions appeared over the next 5
days and the eruption lasted for 10 days. Six months later, on the follow-up, the baby was
asymptomatic, with normal psychomotor development Haematological,
biochemical, cardiological and endocrinological tests were also normal.
Antibodies to Coxsackievirus B3 were 1/64 and 1/128 in the patient’s and
mother’s serum respectively.Conclusions:) a) Coxsackievirus infection
should be considered in the differential diagnosis of a vesiculopapular
crusted rash in the neonate.
b) The virus transmission in our case was transplacental since the
cutaneous lesions were apparent at birth and the virus was detected in both
mother’s and neonate’s seum. c) RT-PCR is a rapid diagnostic procedure with
high sensitivity and specificity for the detection of viral infections. Its
application is a challenge for
the early diagnosis of a congenital infection allowing prompt clinical intervention.