These latter syndromes are the most troublesome in terms of their confusion with other bacterial and viral pathogens, which may lead to unnecessary treatments and diagnostic tests.1 Table 1 lists the CNS syndromes associated with non-polio enteroviruses. The causative virus and clinical manifestations of disease vary depending upon the host. Complications and poor outcome generally occur when infection is early, that is within the first day or two of life, suggesting prenatal acquisition of infection.4 Enterovirus infection in the neonate is characterized by the sudden onset of fever, irritability and poor feeding. Headache and photophobia are almost universally reported.1 Neurologic abnormalities are rare. Enteroviral encephalitis is a less common, but more severe, disease than aseptic meningitis.
Patients generally have global neurologic depression.
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. Primary monkey kidney, human diploid fibroblast and heteroploid cell lines are used. Attempts to develop a direct antigen detection test have been hampered by the serologic diversity of enteroviruses. Likewise, microneutralization assays that measure type-specific antibody are limited because of such diversity.