Abstract
BACKGROUND: Prior reported cases of stillbirth and neonates infected with enteroviruses suggest transplacental infection. We present a case of fetal infection with coxsackievirus B3, diagnosed antenatally and resulting in live birth. CASE: A pregnant woman presented at 26 weeks with fetal tachycardia and non-immune hydrops fetalis. Coxsackievirus B3 was cultured from amniotic fluid. Maternal antibody to coxsackievirus B3 was positive at 1:512. At 32 weeks, the fetus deteriorated and was delivered. Cord blood antibody to coxsackievirus B3 was positive at a higher titer. Following neonatal death, brain and placental tissues were positive for enterovirus ribonucleic acid by polymerase chain reaction. CONCLUSION: Intrauterine infection by enteroviruses should be considered in the differential diagnosis of non-immune hydrops fetalis. Antenatal diagnosis of coxsackievirus B3 infection is associated with poor outcome.
Full Text
The Full Text of this article is available as a PDF (55.1 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Abzug M. J., Keyserling H. L., Lee M. L., Levin M. J., Rotbart H. A. Neonatal enterovirus infection: virology, serology, and effects of intravenous immune globulin. Clin Infect Dis. 1995 May;20(5):1201–1206. doi: 10.1093/clinids/20.5.1201. [DOI] [PubMed] [Google Scholar]
- Bates H. R., Jr Coxsackie virus B3 calcific pancarditis and hydrops fetalis. Am J Obstet Gynecol. 1970 Feb 15;106(4):629–630. doi: 10.1016/0002-9378(70)90058-x. [DOI] [PubMed] [Google Scholar]
- Brady W. K., Purdon A., Jr Intrauterine fetal demise associated with enterovirus infection. South Med J. 1986 Jun;79(6):770–772. doi: 10.1097/00007611-198606000-00032. [DOI] [PubMed] [Google Scholar]
- Euscher E., Davis J., Holzman I., Nuovo G. J. Coxsackie virus infection of the placenta associated with neurodevelopmental delays in the newborn. Obstet Gynecol. 2001 Dec;98(6):1019–1026. doi: 10.1016/s0029-7844(01)01625-8. [DOI] [PubMed] [Google Scholar]
- Modlin J. F., Bowman M. Perinatal transmission of coxsackievirus B3 in mice. J Infect Dis. 1987 Jul;156(1):21–25. doi: 10.1093/infdis/156.1.21. [DOI] [PubMed] [Google Scholar]
- Modlin J. F. Perinatal echovirus and group B coxsackievirus infections. Clin Perinatol. 1988 Jun;15(2):233–246. [PubMed] [Google Scholar]
- Rotbart H. A., Webster A. D., Pleconaril Treatment Registry Group Treatment of potentially life-threatening enterovirus infections with pleconaril. Clin Infect Dis. 2001 Jan 15;32(2):228–235. doi: 10.1086/318452. [DOI] [PubMed] [Google Scholar]
- Sauerbrei A., Glück B., Jung K., Bittrich H., Wutzler P. Congenital skin lesions caused by intrauterine infection with coxsackievirus B3. Infection. 2000 Sep;28(5):326–328. doi: 10.1007/s150100070029. [DOI] [PubMed] [Google Scholar]
- Smalling Thomas W., Sefers Susan E., Li Haijing, Tang Yi-Wei. Molecular approaches to detecting herpes simplex virus and enteroviruses in the central nervous system. J Clin Microbiol. 2002 Jul;40(7):2317–2322. doi: 10.1128/JCM.40.7.2317-2322.2002. [DOI] [PMC free article] [PubMed] [Google Scholar]