Outcome of paediatric acute flaccid myelitis associated with enterovirus D68: a case series
Outcome of paediatric acute flaccid myelitis associated with enterovirus D68: a case series
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DOI：
10.1111/dmcn.14096
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发表时间：
2019-03-01
影响因子：
3.8
通讯作者：
Quigley, Alan
中科院分区：
文献类型：
--
作者：
Kirolos, Amir;Mark, Kate;Quigley, Alan
肠道病毒D68(EV-D68)是一种与急性弛缓性脊髓炎(AFM)相关的新发感染。近年来，与EV-D68感染相关的AFM病例有所增加，因果联系的证据也在不断增加。然而，我们对EV-D68的流行病学、临床特征、预后和神经后遗症的了解需要持续的监测和调查。我们报告了五例AFM病例，这些病例以前通常是在2016年9月至10月期间在苏格兰东南部发育中的儿童(2-6岁)感染EV-D68后发生的(均在鼻咽吸出物中检测到)。所有病例均有明显的神经系统症状，其中两例因呼吸麻痹需要重症监护支持。在18个月的随访中，两例患者仍然依赖呼吸机，其他患者需要进行社区康复。这些病例是欧洲报告的与EV-D68有关的最大的AFM儿科聚集性病例之一。流行病学和临床信息增加了知识库，18个月的结果将有助于临床医生为家庭提供咨询。
Enterovirus D68 (EV-D68) is an emerging infection associated with acute flaccid myelitis (AFM). Cases of AFM associated with EV-D68 infection have increased in recent years and the evidence for a causal link is growing. However, our understanding of the epidemiology, clinical features, prognosis, and neurological sequelae of EV-D68 requires ongoing surveillance and investigation. We report five cases of AFM in previously typically developing children (2-6y) from South East Scotland during September and October 2016 after infection with EV-D68 (all detected in the nasopharyngeal aspirates). All cases presented with significant neurological symptoms, which were severe in two cases requiring intensive care support because of respiratory paralysis. At 18-month follow-up, two cases remain ventilator-dependent with other cases requiring ongoing community rehabilitation. These cases represent one of the largest reported paediatric cluster of AFM associated with EV-D68 in Europe. The epidemiology and clinical information add to the knowledge base and the 18-month outcome will help clinicians to counsel families.