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Enterovirus Infections

Artigo da semana

Asif Noor, Leonard R. Krilov. Pediatrics in Review Dec 2016, 37 (12) 505-515; DOI: 10.1542/pir.2016-0103

Education Gap

Clinicians must learn to recognize the spectrum of clinical syndromes associated with enteroviruses. Examples include the association of asthma exacerbation with enterovirus D68 and the association of acute eczema flare-up with coxsackievirus A16.

Objectives

After completing this article, readers should be able to:

    Understand the epidemiology of enterovirus infections.

    Recognize the wide spectrum of clinical presentations with enterovirus infection.

    Plan appropriate laboratory evaluation for enterovirus infection.

Case Scenario

During Monday morning clinic in mid-July, you refer 2 cases to the emergency department (ED). The first is a 2-week-old neonate who has had 1 day of decreased oral intake and a temperature of 102°F (38.9°C) at your clinic. The baby appears alert with normal findings on physical examination. Later in the morning you receive an update call from the ED attending physician. Examination of the cerebrospinal fluid (CSF) shows pleocytosis with 55 white blood cells/μL but normal glucose (68 mg/dL) and protein (90 mg/dL) measurements. The Gram stain is negative. The CSF is positive for enterovirus (EV) by polymerase chain reaction (PCR) assay.

The second case is a 5-year-old boy with a history of asthma who has had a cough for 3 days and difficulty breathing for 1 day. He does not respond to 2 back-to-back treatments with inhaled albuterol, so you refer him to the ED. He is subsequently admitted to the pediatric intensive care unit for management of status asthmaticus. A nasopharyngeal multiplex film array assay is positive for EV/rhinovirus.

» O artigo está em: http://pedsinreview.aappublications.org/content/37/12/505

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