Complications and poor outcome generally occur when infection is within the first day or two of life, suggesting prenatal acquisition of infection. Enterovirus infection in the neonate is characterized by the sudden onset of fever, irritability, and poor feeding. One fourth of children may have diarrhea, vomiting, and rash described as macular or maculopapular. Headache and photophobia are almost universally reported. Neurologic abnormalities are rare.
Enteroviral encephalitis is a less common, but more severe, disease than aseptic meningitis.
Patients generally have global neurologic depression. Immunocompromised adults and children who have agammaglobulinemia are susceptible to chronic meningitis or meningoencephalitis, which may last years before an ultimately fatal outcome. The availability of PCR has provided a better understanding of the clinical spectrum of chronic enteroviral meningo- encephalitis. In 1974, enterovirus 71 was discovered after a series of patients presented with severe neurologic disease. This particular enterovirus has a propensity to cause paralytic disease, as do coxsackievirus A7 and enterovirus 70.