A neonate presented with severe enteroviral sepsis, prompting consideration of pocapavir treatment. Rapid viral sequencing identified Enterovirus D68, a strain typically associated with respiratory illness, not neonatal sepsis, and importantly, one not susceptible to pocapavir. This case highlights the critical challenge of interpreting rapid sequencing results in real-time clinical decision-making. The discrepancy between the expected enterovirus serotypes in neonatal sepsis and the sequencing finding, coupled with the drug's ineffectiveness against the identified strain, underscores the limitations of relying solely on sequencing without considering clinical context and drug susceptibility data for novel antiviral therapies.
Key note: Rapid viral sequencing must be interpreted cautiously, integrating clinical context and drug susceptibility, to avoid inappropriate treatment decisions.