Pediatric Enteroviral Infections Treatment & Management

Updated: Jun 16, 2017
  • Author: Nicholas John Bennett, MBBCh, PhD, MA(Cantab), FAAP; Chief Editor: Russell W Steele, MD  more...
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Treatment

Medical Care

Unfortunately, no specific antiviral medication or treatment is available for an enteroviral infection. The best care is provided through supportive measures. Fluid hydration and antipyretics are the mainstays of care for a viral syndrome.

  • In patients with severe illness, if a bacterial infection is suspected, antibiotics are administered at the physician’s discretion. Test results, such as polymerase chain reaction (PCR) test results from cerebrospinal fluid (CSF) samples, require 24 hours to return, and a positive result does not necessarily eliminate a bacterial infection. Thus, the use of cultures is important.
  • Corticosteroids have been proposed to have a beneficial effect on myocarditis, but no significant improvement has been demonstrated. Furthermore, because of deleterious side effects, steroids are not recommended for treatment.
  • Intravenous immune globulin (IVIG) has been suggested to be beneficial in the outcome of myocarditis because of immunoglobulin G (IgG) and T-cell modulation. Other indications include possible efficacy in infections in newborns and patients with agammaglobulinemia.
  • Although not approved by the US Food and Drug Administration, (FDA), pleconaril may play a role in the treatment plan in the future. Pleconaril is no longer being manufactured, but alternative antivirals are currently in development. [19]
  • The best medical care involves continued efforts for worldwide poliovirus vaccination.
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Consultations

See the list below:

  • If poliomyelitis is suspected, consultation with a neurologist and a physical medicine specialist is helpful. Furthermore, CDC notification is required because they are responsible for virus surveillance. The CDC investigates cases of suspected polio and helps to identify the etiology of the case.
  • For nonpoliovirus enteroviruses, no consultations are specifically required, but the physician should address individual clinical situations.
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Diet

See the list below:

  • Patients can continue with a normal diet.
  • Soft foods and liquids are appeasing to children with herpangina.
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Activity

See the list below:

  • As with any illness, children should avoid vigorous activity that may contribute to fluid losses and exhaustion.
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