Enterovirus neurological disease and bacterial coinfection in very young infants with fever

Abstract

Background: Very little information exists on simultaneous infections by viruses and bacteria in infants with fever without source (FWS).

Objectives: To investigate the incidence of bacterial coinfection in infants up to 3 months of age with neurological viral infection.

Study design: Prospective study performed in infants below 90 days of age attending the emergency room of two public hospitals in Spain for FWS. Those who had viral screening performed in CSF, together with blood, CSF and urine cultures were included. Herpes virus, EV and HPeV detection in CSF was performed by PCR. Coinfections between viruses in CSF and serious bacterial infections were described.

Results: 119 Infants less than 90 days of age were recruited. Forty-five (38%) had viral infection of the central nervous system, and in 8 of them (17.7%) we found a concurrent bacterial infection: 7 urinary tract infections (UTI) and 1 sepsis. In all cases, the virus identified in CSF was EV.

Conclusions: Bacterial infections were frequent in young infants with viral neurological infections associated to EV. Urinary tract infection was the most common bacterial disease.

Keywords: Coinfection; Enterovirus; Fever; Infants; Meningitis; Urinary tract infections.