Congenital Coxsackievirus B5 Infection: Report of One Case

先天性克沙奇B5型病毒感染：一病例報告

高羽璇(Yu-Hsuan Kao) ； 洪漢陽(Han-Yang Hung) ； 紀鑫(Hsin Chi)

《Acta Paediatrica Taiwanica》 46卷5期 (2005/10) Pp. 321-323

https://doi.org/10.7097/APT.200510.0321

摘要

腸病毒感染於嬰幼兒及孩童時期非常普遍，可能導致肝炎、腦炎、心肌炎等致命性併發症。新生兒腸病毒感染亦能藉由母親的子宮頸分泌物或排泄物，或者後天由醫護單位之流行性新生兒腸病毒感染而得病。新生兒腸病毒感染的預後主要由從母體獲得被動免疫抗體之有無來決定，因此嚴重之新生兒腸病毒感染，通常發生於產後一星期內，母親之被動免疫抗體還未發展或仍未傳給新生兒的時期。我們報告一位先天性克沙奇B5型病毒感染的死亡個案，母親於產前九天開始發燒一個禮拜，並無任何合併症狀。其就讀於幼稚園的四歲姊姊，於個案出生前二週有發燒與感冒症狀。媽媽在產前兩天即感覺胎動減少，因此緊急剖腹產。病患於出生後即有發燒、黃疸、昏迷、抽搐、全身瘀青、呼吸窘迫合併發紺、及肝脾腫大等症狀。於母親及病患之喉頭培養皆分離出克沙奇B5型病毒株。因而推測，病患是由母體胎盤垂直感染而致病。

關鍵字

克沙奇B5型病毒 ； 新生兒 ； 腸病毒 ； 垂直感染

並列摘要

In infants and children, enterovirus (EV) infections are very common. In neonates, EV infections may lead to fatal myocarditis, encephalitis, or necrotizing hepatitis. Transplacental viremia before delivery is possible but has only been demonstrated occasionally. The presence or absence of passively acquired maternal antibody specific for the infecting EV serotype plays the most important role in neonatal EV infections. We report a fatal case of congenital coxsackievirus B5 infection, confirmed by culture of the virus from the patient's throat and rectal swab and from his mother's throat. The mother had suffered from fever for 1 week since 9 days before delivery. Fever subsided 2 days before the day of delivery, but absence of fetal movements was noted. The newborn's 4-yearold elder sister also had suffered from fever with upper respiratory symptoms during the same period. Fever occurred in this baby immediately after birth by cesarean section, suggesting the presence of transplacental virus transmission.

並列關鍵字

coxsackievirus B5 ； neonate ； enterovirus ； vertical transmission