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

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.