# Enteroviral Meningitis-Associated Respiratory Deterioration in a Neonate Treated With High-Flow Nasal Cannula Therapy

## TL;DR

A newborn with enteroviral meningitis improved with high-flow nasal cannula therapy, which may help prevent more invasive treatments.

## Contribution

This case highlights the potential of high-flow nasal cannula therapy in managing central hypoventilation in neonates with viral meningitis.

## Key findings

- HFNC therapy stabilized respiratory rate and oxygen saturation in a neonate with enteroviral meningitis.
- HFNC may prevent the need for intubation by providing mild positive airway pressure and influencing respiratory drive.

## Abstract

Enteroviral meningitis is a common cause of aseptic meningitis in infants, yet respiratory deterioration, including central hypoventilation, is seldom emphasized. High-flow nasal cannula (HFNC) therapy may offer benefits beyond oxygen delivery. We report a case of a six-day-old term boy with enteroviral meningitis caused by coxsackievirus B2. He developed intermittent oxygen desaturation, bradypnea, and hypercapnia that were unresponsive to standard oxygen supplementation. HFNC rapidly stabilized his respiratory rate and oxygen saturation. This case suggests that HFNC may be a useful noninvasive option for central hypoventilation in viral meningitis. Its potential mechanisms include providing mild positive airway pressure, reducing dead space, and influencing central respiratory drive. Early recognition and timely initiation of HFNC could help prevent intubation and mechanical ventilation in similar cases.