柯萨奇病毒A6感染致足月新生儿NEC、肠穿孔一例

Necrotizing enterocolitis and intestinal perforation in a term infant caused by Coxsackievirus A6:a case report

新生儿肠道病毒感染以隐匿感染为主,症状不典型,但可发生严重并发症,甚至导致死亡,可引起新生儿病房暴发性感染。该文报道1例因感染柯萨奇病毒(CV)A6导致坏死性小肠结肠炎、肠穿孔、感染性休克的新生儿。患儿为女性,因皮肤黄染及排血便而入院,结合临床表现及完善相关检查后考虑为坏死性小肠结肠炎、败血症。经予积极综合治疗后,包括禁食、胃肠减压、扩容、抗感染、输注血液制品等,患儿于住院第28日痊愈并出院。患儿出院后大便逆转录PCR结果回报:住院第2日、第23日大便CV A6均阳性,遂补充诊断为新生儿CV感染。新生儿败血症需重视肠道病毒感染可能,及时进行病原学检测十分重要。

Neonatal enterovirus(EV) is mainly manifested with occult infection and atypical symptoms.However,it may cause severe complications,and even death.It can also lead to the outbreak of nosocomial infection in the neonatal ward.In this article,one female case of neonatal necrotizing enterocolitis,intestinal perforation and septic shock caused by Coxsackievirus(CV) A6 infection was reported.She was admitted to hospital due to yellow skin and bloody stool.The possibility of necrotizing enterocolitis and septicemia was considered according to clinical manifestations combined with relevant examinations.After active and comprehensive treatment including fasting,gastrointestinal decompression,volume expansion,anti-infection,and infusion of blood products,the neonate was cured and discharged.At the 2 nd and 23 rd d after hospitalization,RT-PCR revealed the stool samples were positive for CV A6.Hence,she was diagnosed with neonatal CV infection.The possibility of EV infection should be considered for neonatal septicemia.It is of significance to deliver detection of the pathogen.