76 Viral Infections in Neonates

Abstract

Infections are an important cause of mortality and morbidity in the neonatal period. In the past viral infections were difficult to diagnose. Since the introduction of sensitive molecular methods such as polymerase chain reaction (PCR) in the identification of viruses the laboratory diagnosis of viral infections in neonates has been improved. Viruses can be transmitted vertically (during the pregnancy or delivery) or horizontally (after birth). Cytomegalovirus is the most common cause of intrauterine infection worldwide leading to neurodevelopmental sequelae and hearing deficits. Herpes simplex virus (HSV) is the important cause of perinatal (during the delivery) or postnatal (after birth) infection. Recently it has been shown that various viruses which are transmitted horizontally (after birth) may also lead to life-threatening diseases such as sepsis and encephalitis. The recognition of these infections may be difficult because of their similarity with bacterial infections. The diagnosis can only be made if the proper PCR is performed. The consequences of systemic enterovirus, parechovirus or rotavirus infection in the neonatal period may be disastrous. In many infants severe white matter damage was documented on cerebral MRI, subsequently leading to neurodevelopmental delay. Because antiviral treatment is not available, preventive measures such as adequate hand hygiene must be taken into account in care of newborn infants. During the presentation the epidemiology, clinical presentation, neuro-imaging (cerebral ultrasonography and MRI) and outcome of infants with various viral infections will be presented. Furthermore the preventive measures will be discussed.