[Significance of congenital mixed viral infection in the pathogenesis of retinopathy of prematurity]. / Znachenie vrozhdennoi smeshannoi virusnoi infektsii v patogeneze retinopatii nedonoshennykh.

Forty-three infants aged 1-5 months with somatic and neurological diseases, including congenital, 18 of these with retrolental fibroplasia (RF) and 25 without RF were examined. Control group consisted of 36 age-matched infants. Based on identification of viral antigens in urine precipitate cells, mixed viral infection was diagnosed in 100% patients and 16.6% healthy babies. Ophthalmotropic ECHO 11 and 19 viruses were detected in 100% patients with RF, 28% patients without RF, and 10% healthy babies, while rubella virus was identified in 83.3, 60, and 8.3%, respectively. The viruses were detected only in association with other enteroviruses: Coxsakie A, B, and entero 69-71. These viruses detected in infants with RF were as a rule present in their mothers. Maternal anamnesis was in all cases aggravated by high risk indicators of vertical transfer of toxigenic enteroviruses to the fetus. The results indicate that congenital mixed viral infection (association of ophthalmotropic ECHO and rubella viruses with toxigenic Coxsakie and entero 69-71 viruses) is involved in the pathogenesis of RF.

Congenital skin lesions caused by intrauterine infection with coxsackievirus B3.

BACKGROUND: Serious neonatal coxsackievirus infections transplacentally acquired in late pregnancy involve primarily the central nervous system, heart, liver and rarely the skin. PATIENTS AND METHODS: A boy born with a disseminated papulovesicular, nodular, bullous and necrotic ulcerated rash at 39 weeks gestational age developed pneumonia, carditis and hepatitis during the first days after birth. Molecular biological and serological methods were used for virological diagnosis. RESULTS: Coxsackievirus B3 (CVB3) was found in throat swabs and/or feces of the neonate and his mother. In addition, there was serological evidence of intrauterine infection. CONCLUSION: Intrauterine transmission of CVB3 during late pregnancy may lead to varicella-like congenital skin lesions.

[Chronic congenital Coxsackie virus infection in the etiology of allergic disease in children]. / Khronicheskaia vrozhdennaia Koksaki-virushaia infektsiia i ee uchastie v étiologii allergicheskikh boleznei, vyiavliaemykh u detei.

The authors prove the involvement of congenital Coxsackie virus infection in the etiology of allergic diseases in children: 1) indications of high risk of vertical transmission of viruses of this group from mothers with persistent infection to children are more incident in the history of mothers whose children develop allergies in comparison with healthy age-matched children (83 vs. 38.8%); 2) Coxsackie viruses are detected in sick children more often than in healthy ones (58.1-81.1 vs. 7.4%); 3) the persistence of Coxsackie A and B viruses is confirmed in the majority of patients examined over time; 4) in the mothers examined in parallel with their sick children Coxsackie viruses were detected virtually as often as in their children; and 5) reduction of endogenous chronic Coxsackie infection by energy metabolism correction in the risk group women during pregnancy prevents the development of allergic diseases in their children.

Intrauterine coxsackie virus, group B type 1, infection: viral cultivation from amniotic fluid in the third trimester.

We report a case that presents clear evidence of an intrauterine infection of twin fetuses with an enterovirus. The mother had signs and symptoms of chorioamniotitis at 34 weeks' gestation. Coxsackie virus, group B type 1 (CVB1), was cultured from amniotic fluid obtained by transabdominal amniocentesis when the membranes of both fetuses were still intact. Delivery occurred vaginally approximately 24 hours later, following spontaneous rupture of membranes. At birth, both twins showed signs of sepsis. Postpartum, CVB1 was recovered from the mother's cervix, and the newborns' cerebrospinal fluid, nasopharyngeal, and rectal swabs. The present significance of this case is discussed.

[An experimental model of the vertical transmission of the Coxsackie-group enteroviruses and its use in developing methods to prevent congenital coxsackievirus infection]. / Eksperimental'naia model' vertikal'noi peredachi énterovirusov gruppy Koksaki i ee ispol'zovanie pri razrabotke metodov profilaktiki vrozhdennoi Koksaki-virusnoi infektsii.

An experimental model of vertical transmission of Coxsackie group enteroviruses was developed in BALB/c mice the first generation of which was infected with Coxsackie A18 virus in the neonatal period. Persistence of the virus was demonstrated in all females of the first generation tested and in 90.9% to 100% of the animals of the next two generations. Cytochemical analysis of the enzyme status of lymphocytes revealed reliable relationship between the depression of energetic metabolism enzymes and the activity of virus amplification in the animals under study. The correction of aerobic respiration in pregnant females by administration of a complex of energy metabolism substrates and cofactors was accompanied by a significant reduction of the virus infection activity in the females and their offsprings as well as by prevention of transplacental infection in some litters. The experimental model of vertical transmission of enteroviruses is proposed for use in the development of methods for prevention of congenital Coxsackie virus infection. The authors express their deep gratitude to the sponsor of the publication--NOVRUZ Co., Turkmenistan.

[Maternal viral infections as a fetal risk factor]. / Infekcje wirusowe u matki jako czynnik zagrozenia plodu.

After a review of the literature reports from recent years viral infections in pregnant women are presented as a fetal and neonatal risk factor. Maternal infections with rubella virus, cytomegalovirus++, hepatitis, Coxsackie B, varicella, herpes, poliomyelitis, parvovirus B19 and HIV are discussed stressing their unfavourable effect on the developing embryo, fetus or newborn.

[The significance of a congenital enterovirus infection in the pathogenesis of transient intrainfectious nephropathy and interstitial nephritis detected in children with influenza-like and acute respiratory diseases]. / Znachenie vrozhdennoi énterovirusnoi infektsii v patogeneze tranzitornoi intrainfektsionnoi nefropatii i interstial'nykh nefritov, vyiavliaemykh u detei pri grippopodobnykh i ostrykh respiratornykh zabolevaniiakh.

The paper presents the data confirming the hypothesis on the involvement of the congenital enteroviral infection in etiology of chronic nephropathy manifesting in children in the presence of influenza-like and acute respiratory infections diseases. 100 relevant children were examined. Family history indicated a high risk of enteroviruses inheritance from mothers who were chronic carriers in 19 out of 20 children with pyelonephritis or interstitial nephritis (95%), in 17 out of 23 children with transitory nephropathy (73.9%) and 16 out of 57 patients without nephropathy (28.1%). Coxsackie enteroviruses (A and B) occurred in the urinary sediment in 82.3, 68.4, 29.5% of the patients from the groups under comparison, respectively. In children free of nephropathy the viruses manifested primarily in the seasons with the highest prevalence of the enteroviral diseases, in those with nephropathy Coxsackie viruses detection rate was not season-related. Recognition of enteroviruses (Coxsackie B, as a rule) was significantly related to the risk of the transmission from the mother. Persistence of the viruses in the cells of the urinary system of children with congenital viral infection seems to run subclinically for a long time. Influenza and other acute respiratory diseases promoted activation of the endogenic infection which resulted in transitory nephropathy or interstitial nephritides.

[The role of congenital Enterovirus infection in the pathogenesis of suppurative and inflammatory diseases in newborn infants]. / Uchastie vrozhdennoi énterovirusnoi infektsii v patogeneze gnoino-vospalitel'nykh zabolevanii u novorozhdennykh.

Newborns with suppurative-inflammatory disease were found to be at high risk of intrauterine infection with Coxsackie enteroviruses from mothers with persistent enterovirus infection; in 54.9%, congenital Coxsackie virus infection was confirmed by virus antigen identification in the urine sediment cells and autopsy material. Coxsackie A viruses were identified in 68.7% of sepsis cases, 42.6% with local purulent infection foci, and in only 6.7% of practically healthy neonates. Specific features of the clinical course are analysed together with the pathohistological picture of congenital enterovirus infection associated with the vertical virus transmission from the mother having a persistent form of this infection. A suggestion is proposed that the severe course of suppurative-inflammatory conditions and the general character of neonatal bacterial infection are largely determined by the immunodeficient states which are etiologically related to congenital enterovirus infections.

Dermal hematopoiesis in neonates: report of five cases.

We report five cases of dermal hematopoiesis in newborn infants. Dermal hematopoiesis, manifested clinically as a blueberry muffin eruption, has been associated with both intrauterine viral infections and congenital hematologic dyscrasias. Of our five patients, four of whom were boys, the cutaneous findings could be attributed to congenital infections in two instances. The infectious agents were cytomegalovirus and coxsackie virus B-2. Two infants had hematologic abnormalities, including twin transfusion syndrome and ABO blood group incompatibility. In our fifth patient a cause was not identified.

Liquefactive necrosis in Coxsackie B encephalitis.

Coxsackieviruses may cause serious illness in infants and children, specifically myocarditis and meningoencephalitis. Central nervous system lesions have been characterized as inflammatory in nature with mononuclear cell infiltration, neuronophagia, and glial nodule formation largely confined to the brain stem and spinal cord. We present two infants with documented Coxsackie B virus infection who also had widespread multifocal areas of liquefaction necrosis unassociated with inflammation. Such areas of bland necrosis, especially in the cerebrum, are unusual in Coxsackie B virus infection, and may provide the morphological substratum of permanent neurologic impairment in children who survive.

[Coxsackie B5 infection in a newborn infant. Meningoencephalitis and myocarditis]. / Infection à coxsackie B5 chez un nouveau-né. Méningo-encéphalite et myocardite.

A coxsackie virus B5 was isolated from a neonate with aseptic meningitis and myocardial dysfunction. This infection is probably acquired in utero: a high level of specific antibodies was found in the mother and the titer increase later on. At 34 months the baby is totally free of sequelae.

Group B coxsackievirus infections in infants younger than three months of age: a serious childhood illness.

From 1970 to 1979 the viral laboratory at the Nassau County Medical Center (NCMC) tested 602 culture specimens that were positive for group B coxsackievirus. Eighty-one of the specimens were from hospitalized infants younger than three months of age with nonfatal infection. The case histories of 77 of these infants, whose medical records were available for study, are reviewed here. Aseptic meningitis was the clinical syndrome seen most frequently (48 of 77 patients). Protein levels in cerebrospinal fluid (CSF) did not rise above 170 mg/dl, and in only three infants did the glucose concentration in CSF fall below 30 mg/dl. Infants were febrile for an average of 3.1 days, and no infant had fever of longer than six days' duration. During 1970-1981, eight newborns whose culture specimens were examined at NCMC died of overwhelming group B coxsackievirus disease. The clinical histories of these eight patients and 33 other fatal cases reported in the literature are reviewed. Three patterns of death were observed. Rapid death occurred in 12 patients aged 2-17 days. In 11 patients a diphasic illness led to death at age 8-24 days. In 18 patients a progressive illness was described. Myocarditis was present in all infants. Pulmonary hemorrhage and liver necrosis occurred in 30 and 18 patients, respectively. Jaundice was more frequently observed in fatal cases. Bleeding diatheses were also reported and probably reflect hepatic necrosis. Twenty-four mothers had evidence of a viral-like infection occurring between 10 days antepartum and five days postpartum. Group B coxsackievirus infection must be considered a serious disease of the newborn, which in our community occurred in 77 of 153,250 live births and accounted for six deaths between 1970 and 1979.

Echovirus 11 infections of newborns with mortality during the 1979 enterovirus season in Milwaukee, Wis.

Echovirus serotype 11 (ECHO-11) was implicated in three neonatal deaths during an enterovirus outbreak from July through October 1979 in Milwaukee. The deaths followed congenital infections acquired in the community during late pregnancy. Two of the three ECHO-11 and one Coxsackie B4 deaths of infants occurred after cesarean section deliveries. Of 225 confirmed echovirus infections, 30 to 45 percent occurred in infants under 60 days old, 54 to 67 percent in the first year of life, and 13 to 25 percent in the over-10 age groups. In 13 cases with onset of symptoms in the first week of life. 8 (including the 4 fatalities) were acquired congenitally; 6 of the 8 were associated with ECHO-11, 2 with ECHO-7, and 1 with Coxsackie B4. ECHO-7 and 30 other predominant strains were isolated during the outbreak, but none was associated with mortality or severe disease in neonates. At a Milwaukee hospital, a temporal association was observed between echovirus infection, particularly ECHO-11, and increased numbers of stillbirths.

[Intrauterine infections in the perinatal period]. / Vnutriutrobnye infektsii v perinatal'nom periode.

The results of examinations of autopsy materials in Leningrad and the data from the literature indicate that infectious diseases occupy a significant place in perinatal mortality. It is emphasized that if the autopsy materials are not sufficiently examined using not only light but also immunofluorescent microscopy, a considerable portion of these infections is not diagnosed and the pathological proprocess in such cases in considered to be aspiration pneumonia, hyaline membrane disease, etc. The paper briefly characterizes intrauterine bacterial infections (listeriasis, syphilis, staphylococcal infections, etc.) with special reference to virus diseases (cytomegaly, herpes infection, lesions caused by respiratory viruses, etc) and mycoplasmosis. It is shown that a relatively high incidence of lesions is caused by respiratory viruses and particularly mycoplasma. The possibility of protozoan and mycotic lesions is also indicated. The frequent occurrence of combined intrauterine infections is emphasized.