ENTEROVIRAL INFECTIONS IN THE IMMUNOCOMPROMISED HOST

In contrast to most viral infections, which are controlled by the cell ular immune system and may cause disease in patients that suffer from a cellular defect, e.g. after transplantation or HIV infection, the en teroviruses cause a lytic infection that is controlled mainly by neutr alising antibody. Severe enteroviral infections are observed with agam maglobulinaemia and in neonates, but usually not in adults with a cell ular immune defect. The main manifestation of the infection in agammag lobulinaemia patients is a slowly progressive meningoencephalitis that is sometimes difficult to diagnose. Patients are treated with intrave nous immunoglobulins, but with variable success. In the neonate, immat urity of the immune system is responsible for severe infections, in pa rticular when transmitted by the mother during delivery. These infecti ons may present as sepsis with hepatic necrosis, meningoencephalitis o r myocarditis. It remains to be established, whether immunoglobulin tr eatment is effective in the neonate with severe enteroviral disease.