Asymptomatic Bradycardia in a Neonate: A Rare Manifestation of Respiratory Syncytial Virus Infection with Literature Review

Dina W Abdulghani,1 Dina Tariq Alafandi2 1Department of Pediatrics, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Pediatric Emergency Department, King Abdullah Specialist Children’s Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaCorrespondence: Dina Tariq Alafandi, King Abdullah Specialized Children’s Hospital, Ar Rimayah, Riyadh, 14611, Saudi Arabia, Email [email protected]: Respiratory syncytial virus (RSV) is a leading cause of pulmonary infections and is associated with significant morbidity and mortality in infants and children under the age of 2 years. Although RSV infection most commonly affects the respiratory system, it has increasingly been linked to cardiovascular manifestations such as conduction abnormalities. Such complications are exceedingly rare in neonates, especially in the absence of clinical signs of infection. Herein, we present the case of a 3-day-old full-term neonate who presented to the emergency department owing to maternal concern of yellowish discoloration of the skin. During assessment, he exhibited multiple episodes of isolated bradycardia necessitating admission to the intensive care unit for further investigation and monitoring. After an extensive work up for bradycardia, he was found to be RSV positive via nasopharyngeal polymerase chain reaction (PCR). He remained hemodynamically stable with resolution of bradycardia episodes after 4 days. This case highlights the importance of recognizing RSV as a potential cause of arrhythmia in newborns, even in the absence of respiratory symptoms and underscores the need for further studies on the cardiovascular effects of RSV.Keywords: cardiac involvement, conduction abnormalities, electrocardiography, respiratory infection