ABSTRACT
Most of the neonatal enteroviral infections reported in the literature are associated
with Coxsackievirus B2-B5 and echovirus 9 and 11. We report a retrospective Coxsackievirus
B1 (CB1) infection in infants less than 2 months of age. Seventeen patients had aseptic
meningitis and 8 had systemic sepsis (multi-organ involvement including meningitis,
impaired liver function, and abnormality in coagulation). The symptoms and signs were
nonspecific and could not be distinguished with bacterial infection on clinical grounds.
Virus isolation was mandatory for diagnosis. Impaired liver function and coagulation
profiles were noted in patients with systemic sepsis, but not in patients with meningitis
only. CSF examination showed some uncommon features of viral meningitis: predominance
of polymorphonuclear cells (PMN) was noted in 62.5% of patients and hypoglycorrhachia
in 64% of patients. The patients with only meningitis recovered completely without
any sequela. One of the eight patients with systemic sepsis died with case fatality
rate 12.5%. Physicians should be aware of the possibility of CB1 virus infection in
young infants during prevalent seasons. Specimens should be sent for viral culture
in patients with meningitis and sepsis to make a definite diagnosis.
Keywords
Coxsackievirus B1 - infant - neonate - meningitis - sepsis
