High C-Reactive Protein Levels During a Benign Neonatal Outbreak of Echovirus Type 7

Thierry Daboval; Emanuela Ferretti; Raymond Duperval

doi:10.1055/s-2006-947157

American Journal of Perinatology, Table of Contents

Am J Perinatol 2006; 23(5): 299-304
DOI: 10.1055/s-2006-947157

High C-Reactive Protein Levels During a Benign Neonatal Outbreak of Echovirus Type 7

Thierry Daboval¹ , Emanuela Ferretti¹ , Raymond Duperval²

¹Pediatric Department, CHUS-Hôpital Fleurimont, Fleurimont, Québec, Canada
²Infection Department, CHUS-Hôpital Fleurimont, Fleurimont, Québec, Canada

Abstract

ABSTRACT

Literature associates neonatal enteroviral infections with high morbidity and mortality. The literature also suggests that high C-reactive protein (CRP) levels are indicators of bacterial infection. We report on high CRP levels, not due to bacterial infection, during an outbreak of neonatal echovirus type 7 infections in the fall of 2002, which had no major complications or mortality.

KEYWORDS

Echovirus type 7 - enterovirus - virus disease - newborn - C-reactive protein

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References

REFERENCES

1 Castro R. Echovirus 7 infection and necrotizing enterocolitis-like symptoms in premature infant. J Perinatol. 2000; 20 558-561
2 Wreghitt T G, Sutehall G M, King A, Gandy G M. Fatal echovirus 7 infection during an outbreak in a special care baby unit. J Infect. 1989; 19 229-236
3 Syriopoulou VPh, Hadjichristodoulou Ch, Daikos G L et al.. Clinical and epidemiological aspects of an enterovirus outbreak in a neonatal unit. J Hosp Infect. 2002; 51 275-280
4 Keyserling H L. Other viral agents of perinatal importance. Varicella, parvovirus, respiratory syncytial virus, and enterovirus. Clin Perinatol. 1997; 24 193-211
5 Morens D M. Enteroviral disease in early infancy. J Pediatr. 1978; 92 374-377
6 Modlin J F. Perinatal echovirus infection: insights from a literature review of 61 cases of serious infection and 16 outbreaks in nurseries. Rev Infect Dis. 1986; 8 918-926
7 Chambon M, Bailly J L, Béguet A et al.. An outbreak due to echovirus type 30 in a neonatal unit in France in 1997: usefulness of PCR diagnosis. J Hosp Infect. 1999; 43 63-68
8 Kazzi N J, Cepeda E E, Budev H. Fatal echovirus type 7 in a premature infant. Am J Perinatol. 1988; 5 236-238
9 Chiesa C, Signore F, Assumma M et al.. Serial measurement of C-reactive protein and interleukin-6 in the immediate postnatal period: reference intervals and analysis of maternal and perinatal confounders. Clin Chem. 2001; 47 1016-1022
10 Bomela H N, Ballot D E, Cory B J, Cooper P A. Use of C-reactive protein to guide duration of empiric antibiotic therapy in suspected early neonatal sepsis. Pediatr Infect Dis J. 2000; 19 531-535
11 Philip A GS, Mills P C. Use of C-reactive protein in minimizing antibiotics exposure: Experience with infants initially admitted to a well-baby nursery. Pediatrics. 2000; 106 e4
12 Franz A R, Steinbach G, Kron M, Pohlandt F. Reduction of unnecessary antibiotic therapy in newborn infants using interleukin-8 and C-reactive protein as marker of bacterial infections. Pediatrics. 1999; 104 447-453
13 Connolly J H, Russel J D, Robinson F LJ, Canavan D A. Echovirus type 7 outbreak in Northern Ireland during 1984. Ulster Med J. 1985; 54 191-195
14 Piraino F F, Sedmak G, Raab K. Echovirus 11 infections of newborns with mortality during the 1979 enterovirus season in Milwaukee, Wis. Public Health Rep. 1982; 97 346-353
15 Cerny E, Kind C, Bachi T. Nosocomial epidemic of echovirus type 7 in a neonatology department. Helv Paediatr Acta. 1983; 38 457-465
16 Isaacs D, Wilkinson A, Moxon E R. Prevention of spread of echovirus 6 in a special-care baby unit. Arch Dis Child. 1985; 60 1205-1206
17 Carolane D J, Long A M, McKeever P A, Hobbs S J, Roome A P. Prevention of spread of echovirus 6 in a special-care baby unit. Arch Dis Child. 1985; 60 674-676
18 Rotbart H A. Enteroviral infections of the central nervous system. Clin Infect Dis. 1995; 20 971-981
19 Modlin J F, Dagan R, Berlin L E, Virshup D M, Yolken R H, Menegus M. Focal encephalitis with enterovirus infections. Pediatrics. 1991; 88 841-845
20 Wilson C W, Stevenson D K, Arvin A M. A concurrent epidemic of respiratory syncytial virus and echovirus 7 infections in an intensive care nursery. Pediatr Infect Dis J. 1989; 8 24-29
21 Jaye D L, Waites K B. Clinical applications of C-reactive protein in pediatrics. Pediatr Infect Dis J. 1997; 16 735-747
22 Hengst J M. The role of C-reactive protein in the evaluation and management of infants with suspected sepsis. Adv Neonatal Care. 2003; 3 3-13
23 Ehl S, Gehring B, Pohlandt F. A detailed analysis of changes in serum C-reactive protein levels in neonates treated for bacterial infection. Eur J Pediatr. 1999; 158 238-242
24 Sasaki K, Fujita I, Hamasaki Y, Miyazaki S. Differentiating between bacterial and viral infection by measuring both C-reactive protein and 2′-5′-oligoadenylate synthetase as inflammatory markers. J Infect Chemother. 2002; 8 76-80
25 De Beer F C, Kirsten G F, Gie R P, Beyers N, Strachan A F. Value of C-reactive protein measurement in tuberculous, bacterial, and viral meningitis. Arch Dis Child. 1984; 59 653-656
26 Peltola H O. C-reactive protein for rapid monitoring of infections of the central nervous system. Lancet. 1982; 1 980-983
27 Tatara R, Imai H. Serum C-reactive protein in the differential diagnosis of childhood meningitis. Pediatr Int. 2000; 42 541-546
28 Hansson L O, Axelsson G, Linne T, Aurelius E, Lindqvist L. Serum C-reactive protein in the differential diagnosis of acute meningitis. Scand J Infect Dis. 1993; 25 625-630
29 Chiesa C, Panero A, Osborn J F, Simonetti A F, Pacifico L. Diagnosis of neonatal sepsis: a clinical and laboratory challenge. Clin Chem. 2004; 50 279-287

Thierry DabovalM.D. F.R.C.P.(C)

Neonatologist, Pediatric Department, CHUS-Hôpital Fleurimont

3001 12e Avenue Nord, Fleurimont, Québec J1H 5N4, Canada