Presentation, diagnosis, and management of XXXX in neonates.

@entity1 @entity295 @entity9488 @entity1910 @entity146 @entity55 @entity5422 @entity49095 @entity448 @entity1003 @entity693 @entity2401 @entity1729 @entity99 @entity221 @entity4092
The nonpoliovirus enteroviruses commonly infect newborns, with consequences ranging from @entity4092 and benign illness, to severe, life-threatening disease. Frequently occurring symptoms include @entity221 , @entity146 , lethargy, @entity448 , and @entity1910 . Although most illnesses are mild, severe disease develops in a subset of newborns infected in the first 2 weeks of life. Severe disease may consist of @entity295 , @entity5422 , @entity2401 , @entity55 , @entity99 , and/or @entity1003 . Substantial mortality rates have been reported, and long-term sequelae may occur among survivors. Risk factors and clinical features associated with severe disease include absence of neutralizing antibody to the infecting serotype, maternal illness prior to or at delivery, prematurity, illness onset within the first few days of life, multiorgan disease, severe @entity99 , positive serum viral culture, and specific infecting serotype (e.g. group B coxsackieviruses and echovirus 11). Whereas the mainstay of diagnosis has traditionally been viral isolation in tissue culture, the polymerase chain reaction has been demonstrated to be more sensitive than culture, highly specific, and rapid. Immunoglobulin has been used as a therapeutic agent for neonates with enterovirus disease; however, clinical efficacy has not been proven. Specific antiviral therapy for enteroviruses is in development. Pleconaril is an investigational agent that inhibits viral attachment to host cell receptors and uncoating of viral nucleic acid. It has broad and potent anti-enterovirus activity, excellent oral bioavailability, and is well tolerated. Some clinical trials have demonstrated benefit in @entity1 and adults with @entity693 , and in adults with @entity1729 caused by picornaviruses (rhinoviruses or enteroviruses). Data summarizing compassionate use for severe @entity9488 (including @entity295 ) also suggest possible benefit. Limited pharmacokinetic data are available in @entity1 and neonates. A multicenter, placebo-controlled, randomized trial of @entity49095 in neonates with severe @entity99 , @entity1003 , and/or @entity2401 is currently being conducted.
