Le infezioni da enterovirus nel neonato e nel lattante

Abstract

Enteroviruses (EV) are a relevant source of infection in paediatric patients. The majority of cases concerns the neonatal period and the first months of life. Due to their extreme epidemiological fluctuations, molecular epidemiology is crucial to understand the circulation of main serotypes in a specific area and period. The gold standard for the diagnosis currently relies on Polymerase Chain Reaction (PCR) assay to detect EV RNA in biological samples (usually cerebrospinal fluid and plasma, but also throat swabs and faeces). EV infections usually have a benign course and prognosis. Nevertheless, they may become life threatening, especially when the onset of symptoms occurs in the first days of life. Mortality is associated with myocarditis, hepatitis and multi-organ failure. Neurodevelopmental sequelae have been reported in cases of severe infection with central nervous system involvement (such as meningo-encephalitis). Even though the use of specific antiviral agents in severe neonatal infections has been reported in single cases or studies including few neonates, the current treatment of EV infections remains mainly supportive and further studies are needed to endorse the use of these drugs in clinical practice.