{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T22:26:56Z","timestamp":1785191216624,"version":"3.55.0"},"reference-count":36,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>In the first 90 days, most meningitis cases are viral. Newborns often show nonspecific symptoms, making early diagnosis difficult but crucial for effective treatment and good outcomes. Cerebro-spinal fluid (CSF) analysis is the gold standard for diagnosis, enabling targeted therapy. We report on a newborn with rare viral meningitis due to herpes simplex virus type 1 and enterovirus coinfection. This uncommon situation complicates diagnostic and therapeutic management. We share our experience and review the limited literature on such neonatal viral coinfections.<\/jats:p>","DOI":"10.3390\/v17060790","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T08:07:58Z","timestamp":1748592478000},"page":"790","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Neonatal Meningitis Due to Herpes Simplex Virus Type 1 and Enterovirus Coinfection: Case Report and Review of the Literature"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7454-9199","authenticated-orcid":false,"given":"Carolina","family":"Coramusi","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Rizzoli","sequence":"additional","affiliation":[{"name":"San Pietro Fatebenefratelli Hospital, Neonatal Intensive Care Unit, Sapienza University, 86100 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Alegiani","sequence":"additional","affiliation":[{"name":"San Pietro Fatebenefratelli Hospital, Neonatal Intensive Care Unit, Sapienza University, 86100 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Bonafoni","sequence":"additional","affiliation":[{"name":"San Pietro Fatebenefratelli Hospital, Neonatal Intensive Care Unit, Sapienza University, 86100 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9820-6557","authenticated-orcid":false,"given":"Cinzia","family":"Auriti","sequence":"additional","affiliation":[{"name":"Departmental Faculty of Medicine, Saint Camillus International University, 00131 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9042-8120","authenticated-orcid":false,"given":"Pasquale","family":"Parisi","sequence":"additional","affiliation":[{"name":"NESMOS Department, Faculty of Medicine & Psychology, Sapienza University, c\/o Sant\u2019 Andrea Hospital, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4675-6405","authenticated-orcid":false,"given":"Maria Eleonora","family":"Scapillati","sequence":"additional","affiliation":[{"name":"San Pietro Fatebenefratelli Hospital, Neonatal Intensive Care Unit, Sapienza University, 86100 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1128\/IAI.74.4.1999-2006.2006","article-title":"Neonatal innate immunity to infectious agents","volume":"74","year":"2006","journal-title":"Infect. Immun."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Petel, D., Barton, M., Renaud, C., Ouchenir, L., Brophy, J., Bowes, J., Khan, S., Bitnun, A., McDonald, J., and Boisvert, A.A. (2020). Enteroviral and herpes simplex virus central nervous system infections in infants <90\u2009days old: A Paediatric Investigators\u2019 Collaborative Network on Infections in Canada (PICNIC) study. BMC Pediatr., 20.","DOI":"10.1186\/s12887-020-02151-4"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1053\/j.semperi.2018.02.007","article-title":"Neonatal nonpolio enterovirus and parechovirus infections","volume":"42","author":"Harik","year":"2018","journal-title":"Semin. Perinatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1086\/427339","article-title":"The role of toll-like receptors in herpes simplex infection in neonates","volume":"191","author":"Belko","year":"2005","journal-title":"J. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1053\/j.semperi.2018.02.004","article-title":"Neonatal herpes simplex virus infections","volume":"42","author":"Pinninti","year":"2018","journal-title":"Semin. Perinatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.clp.2021.03.003","article-title":"Neonatal Herpes Simplex Virus Disease: Updates and Continued Challenges","volume":"48","author":"Samies","year":"2021","journal-title":"Clin. Perinatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.clp.2014.10.005","article-title":"Neonatal herpes simplex virus infection: Epidemiology and treatment","volume":"42","author":"James","year":"2015","journal-title":"Clin Perinatol."},{"key":"ref_8","unstructured":"Kimberlin, D.W., Brady, M.T., Jackson, M.A., and Long, S.S. (2015). Enterovirus (nonpoliovirus). American Academy of Pediatrics Red Book\u00ae: 2015 Report of the Committee on Infectious Diseases, American Academy of Pediatrics."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Bucci, S., Coltella, L., Martini, L., Santisi, A., De Rose, D.U., Piccioni, L., Campi, F., Ronchetti, M.P., Longo, D., and Lucignani, G. (2022). Clinical and Neurodevelopmental Characteristics of Enterovirus and Parechovirus Meningitis in Neonates. Front. Pediatr., 10.","DOI":"10.3389\/fped.2022.881516"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1684\/vir.2020.0862","article-title":"Virus herp\u00e8s simplex et infections du syst\u00e8me nerveux central: Enc\u00e9phalite, m\u00e9ningite, my\u00e9lite [Herpes simplex virus and central nervous system infections: Encephalitis, meningitis, myelitis]","volume":"24","author":"Rozenberg","year":"2020","journal-title":"Virologie"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1542\/peds.108.2.230","article-title":"Safety and efficacy of high- dose intravenous acyclovir in the management of neonatal herpes simplex virus infections","volume":"108","author":"Kimberlin","year":"2001","journal-title":"Pediatrics"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1093\/jpids\/piab105","article-title":"Neonatal Herpes Simplex Virus Infection: Epidemiology and Outcomes in the Modern Era","volume":"11","author":"Melvin","year":"2022","journal-title":"J. Pediatric. Infect. Dis. Soc."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Pfefferle, S., Christner, M., Aepfelbacher, M., L\u00fctgehetmann, M., and Rohde, H. (2020). Implementation of the FilmArray ME panel in laboratory routine using a simple sample selection strategy for diagnosis of meningitis and encephalitis. BMC Infect. Dis., 20.","DOI":"10.1186\/s12879-020-4904-4"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Ghabouli Shahroodi, M.J., Ghazvini, K., Sadeghi, R., and Sasan, M.S. (2016). Enteroviral Meningitis in Neonates and Children of Mashhad, Iran. Jundishapur J. Microbiol., 9.","DOI":"10.5812\/jjm.19955"},{"key":"ref_15","first-page":"78","article-title":"Infection n\u00e9onatale pr\u00e9coce \u00e0 ent\u00e9rovirus: Quand faut-il y penser? Cas cliniques et revue de la literature [Early Enterovirus Neonatal Infection: When Should We think About It?]","volume":"71","author":"Lagae","year":"2016","journal-title":"Rev. Med. Liege."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"484","DOI":"10.33588\/rn.6712.2018203","article-title":"Meningitis viricas neonatales. Importancia de la reaccion en cadena de la polimerasa en su diagnostico [Neonatal viral meningitis. The importance of the polymerase chain reaction in their diagnosis]","volume":"67","year":"2018","journal-title":"Rev Neurol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e241405","DOI":"10.1136\/bcr-2020-241405","article-title":"Prolonged fever and hyperferritinemia: A puzzling diagnosis of neonatal herpes simplex virus infection during COVID-19 pandemic","volume":"14","author":"Badawy","year":"2021","journal-title":"BMJ Case Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e29024","DOI":"10.1002\/jmv.29024","article-title":"Neonatal herpes simplex virus infection: From the maternal infection to the child outcome","volume":"95","author":"Bompard","year":"2023","journal-title":"J. Med. Virol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Ayoub, H.H., Chemaitelly, H., and Abu-Raddad, L.J. (2019). Characterizing the transitioning epidemiology of herpes simplex virus type 1 in the USA: Model-based predictions. BMC Med., 17.","DOI":"10.1186\/s12916-019-1285-x"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.1001\/jama.2022.19061","article-title":"Viral Shedding 1 Year Following First-Episode Genital HSV-1 Infection","volume":"328","author":"Johnston","year":"2022","journal-title":"JAMA"},{"key":"ref_21","first-page":"1615","article-title":"Enteroviruses: Classification, Diseases They Cause, and Approaches to Development of Antiviral Drugs","volume":"82","author":"Nikonov","year":"2017","journal-title":"Biochemistry"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"S75","DOI":"10.1016\/S0378-3782(14)70023-4","article-title":"Human enterovirus and parechovirus infections in newborns with sepsis like illness and neurologic disorders","volume":"90","author":"Piralla","year":"2014","journal-title":"Early Hum. Dev."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Zhang, M., Wang, H., Tang, J., He, Y., Xiong, T., Li, W., Qu, Y., and Mu, D. (2021). Clinical characteristics of severe neonatal enterovirus infection: A systematic review. BMC Pediatr., 21.","DOI":"10.1186\/s12887-021-02599-y"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e29934","DOI":"10.1002\/jmv.29934","article-title":"Israeli neonatal herpes simplex infection: Unique epidemiology and clinical profile","volume":"96","author":"Lagziel","year":"2024","journal-title":"J. Med. Virol."},{"key":"ref_25","unstructured":"Demmler-Harrison, G.J., Kaplan, S.L., and Armsby, C. (2025, May 26). Neonatal Herpes Simplex Virus (HSV) Infection: Clinical Features and Diagnosis. UpToDate. Available online: https:\/\/doctorabad.com\/uptodate\/d\/topic.htm?path=neonatal-herpes-simplex-virus-infection-clinical-features-and-diagnosis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2300253","DOI":"10.2807\/1560-7917.ES.2023.28.22.2300253","article-title":"Severe and fatal neonatal infections linked to a new variant of echovirus 11, France, July 2022 to April 2023","volume":"28","author":"Grapin","year":"2023","journal-title":"Euro Surveill."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1055\/s-0031-1296027","article-title":"Antenatal and postnatal diagnosis of coxsackie b4 infection: Case series","volume":"2","author":"Schneider","year":"2011","journal-title":"Am. J. Perinatol. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e929","DOI":"10.1542\/peds.2006-0554","article-title":"Probable intrafamilial transmission of coxsackievirus b3 with vertical transmission, severe early-onset neonatal hepatitis, and prolonged viral RNA shedding","volume":"118","author":"Cheng","year":"2006","journal-title":"Pediatrics"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1186\/s12985-018-0978-7","article-title":"Adverse effects of maternal enterovirus infection on the pregnancy outcome: A prospective and retrospective pilot study","volume":"15","author":"Khediri","year":"2018","journal-title":"Virol. J."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Longo, C., Saito, M., Castro, P.T., Traina, E., Werner, H., Elito J\u00fanior, J., and Araujo J\u00fanior, E. (2024). Coxsackievirus Group B Infections during Pregnancy: An Updated Literature Review. J. Clin. Med., 13.","DOI":"10.3390\/jcm13164922"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1038\/pr.2016.191","article-title":"Treatment of perinatal viral infections to improve neurologic outcomes","volume":"81","author":"Muller","year":"2017","journal-title":"Pediatr Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1093\/clinids\/20.5.1201","article-title":"Neonatal enterovirus infection: Virology, serology, and effects of intravenous immune globulin","volume":"20","author":"Abzug","year":"1995","journal-title":"Clin. Infect. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1016\/j.jmii.2019.08.018","article-title":"Enteroviral infection in neonates","volume":"52","author":"Chuang","year":"2019","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1080\/1064744042000210357","article-title":"Antenatal diagnosis of intrauterine infection with coxsackievirus B3 associated with live birth","volume":"12","author":"Ouellet","year":"2000","journal-title":"Infect. Dis. Obstet. Gynecol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1097\/00006454-200104000-00022","article-title":"Severe neonatal enteroviral hepatitis treated with pleconaril","volume":"20","author":"Aradottir","year":"2001","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1086\/318452","article-title":"Treatment of potentially life-threatening enterovirus infections with pleconaril","volume":"32","author":"Rotbart","year":"2001","journal-title":"Clin. Infect. Dis."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/6\/790\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:43:52Z","timestamp":1760031832000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/6\/790"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,30]]},"references-count":36,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["v17060790"],"URL":"https:\/\/doi.org\/10.3390\/v17060790","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,30]]}}}