Richter M.F.,Auf der Bult Kinder und Jugendkrankenhaus |
Guthmann F.,Auf der Bult Kinder und Jugendkrankenhaus |
Richter J.W.,Auf der Bult Kinder und Jugendkrankenhaus
Padiatrische Praxis | Year: 2017
In newborn infants infections are a feared risk for morbidity and mortality in a considerable number of cases. In general bacterial infection seemed to be the common pathogen but meanwhile it is known that up to 25% of undetected sepsis is caused by viral agents, mostly picornaviridae. This is the reason why, bacteriological as well as virological diagnostics is very important at the earliest time. Infections with picornaviridae show a very widespread clinical presentation. This fact leads to thorough investigations (lab, sonography) to pre-estimate possible severe complications. As described in older and immnunocompetent patients, infection with picornaviridae leads to harmless nonspecific symptoms like common cold, gastroenteritis, rush. But in immunocompromised patients, especially in newborns, the symptoms can reach to aseptic meningitis, necrotizing hepatitis or enterocolitis and myocarditis. These severe causes of disease are often combined with hemolytic anemia and/or coagulation disorder. Indeed there exist no specific therapy strategies in these cases, but in case reports several times immunoglobulin therapy improved the cause of disease. In diagnostics it is not merely the virological testing but rather the medical imaging, like abdominal sonography and echocardiography, which detects ascites, hepatitis signs and myocardial insufficiency. It should be performed repetitively because specific symptoms may occur suddenly. On a regular basis it is important to check for coagulopathy and to treat disseminated intravascular coagulation (DIC) consequently if necessary. Despite all procedures a lethal outcome occurs in some cases especially in patients of NICU (neonatal intensive care units). For prevention it is very important to regard all hygienic procedures. In case of nosocomial transmission isolation of index patients has to be performed as soon as possible.