Abstract
Neonatal cardiogenic shock most commonly occurs due to critical congenital heart disease, sepsis, metabolic disorder or arrhythmias. In particular, enterovirus infections are common in the neonatal period, and patients can present with fulminant myocarditis. Early recognition is imperative due to its high morbidity and mortality without prompt and aggressive treatment. We present the successful treatment of fulminant neonatal enteroviral myocarditis in a pair of monochorionic diamniotic twins with cardiopulmonary support, intravenous immunoglobulin and pocapavir, an enteroviral capsid inhibitor. The twins took an almost exact parallel hospital course, including day of extracorporeal membrane oxygenation (ECMO) cannulation, day of ECMO decannulation, improvement of cardiac function, discharge and status at follow-up. While it was difficult to assess the relative contribution of each intervention, our case shows promise in the use of pocapavir for treatment of severe enteroviral infections. Remarkably, both twins demonstrated remarkable recovery within 2 weeks, underscoring that early aggressive cardiopulmonary support, and potentially pocapavir, contributed to their recovery.
References
Feb 1, 1988·Pediatrics in Review·M H Lees, D H King
Dec 23, 1999·The Pediatric Infectious Disease Journal·M H Sawyer
Aug 24, 2004·Archives of Disease in Childhood. Fetal and Neonatal Edition·D InwaldM Burch
Jun 4, 2005·BMC Cardiovascular Disorders·Joan L RobinsonTerry P Klassen
Feb 2, 2006·Heart·N AmabileC Ovaert
Mar 21, 2008·International Journal of Cardiology·Duck Won BangYoung Joo Kwon
Mar 24, 2009·Seminars in Fetal & Neonatal Medicine·Marc Tebruegge, Nigel Curtis
Mar 28, 2009·Critical Care Medicine·Joe BrierleyAaron Zuckerberg
Jul 29, 2009·Antimicrobial Agents and Chemotherapy·M Steven ObersteMarc S Collett
Nov 7, 2009·Current Treatment Options in Neurology·Sumit ParikhThe Mitochondrial Medicine Society
Nov 17, 2009·The Journal of Perinatal & Neonatal Nursing·Jeannine G Jones, Sandra L Smith
Oct 1, 2001·Paediatrics & Child Health·A B Dancea
May 7, 2010·Archives of Disease in Childhood. Fetal and Neonatal Edition·Matthias W FreundMalgorzata A Verboon-Maciolek
Jul 14, 2010·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Kate MaddenSatish K Rajagopal
Jul 16, 2010·Journal of Paediatrics and Child Health·Geethanjali RamachandraPadmanabhan Ramnarayan
Oct 27, 2010·Pharmacotherapy·Kristin M Santa
Jan 5, 2011·The Journal of Pediatrics·Sarah A TeeleRavi R Thiagarajan
Apr 8, 2014·Neuropathology : Official Journal of the Japanese Society of Neuropathology·Stephanie J BisselClayton A Wiley
Sep 18, 2014·The Pediatric Infectious Disease Journal·Sanet Torres-TorresRussell J McCulloh
Sep 26, 2017·Journal of Investigative Medicine High Impact Case Reports·Samuel G WittekindRyan A Moore
Citations
Dec 11, 2019·Antimicrobial Agents and Chemotherapy·Eric RhodenWilliam C Weldon
Oct 14, 2020·Nature Reviews. Cardiology·Carsten TschöpeSophie Van Linthout
Mar 17, 2021·BMC Pediatrics·Meng ZhangDezhi Mu