Clinical spectrum of enterovirus 71 infection in children in southern Taiwan, with an emphasis on neurological complications
Clinical spectrum of enterovirus 71 infection in children in southern Taiwan, with an emphasis on neurological complications
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DOI：
10.1086/520149
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发表时间：
1999-07-01
影响因子：
11.8
通讯作者：
Yeh, TF
中科院分区：
文献类型：
--
作者：
Wang, SM;Liu, CC;Yeh, TF
1998 年，台湾爆发了肠道病毒 71 型（EV71）感染疫情。对 97 名经病毒培养证实感染 EV71 的患者的临床谱和实验室检查结果进行了分析。百分之八十七的患者年龄小于 5 岁。 79%的儿童出现手足口综合症，35%的儿童出现中枢神经系统（CNS）症状，其中9例死亡。主要的神经系统症状是肌阵挛（68%）、呕吐（53%）和共济失调（35%）。脑干脑炎是本次疫情期间EV71中枢神经系统受累的主要特征。磁共振成像和病理结果表明，中脑、笔和髓质是目标区域。 EV71 脑干脑炎可以表现为小脑体征和最初轻微、可逆的病程，也可以表现为严重的神经源性休克和神经源性肺水肿 (NPE)，导致致命的结果。脑干脑炎突然进展为神经源性休克和 NPE，表明本次流行病的预后不良。为了提高生存机会，必须尽早积极治疗并密切监测神经体征。
An outbreak of enterovirus 71 (EV71) infection occurred in Taiwan in 1998. The clinical spectrums and laboratory findings for 97 patients with virus culture-proven EV71 infections were analyzed. Eighty-seven percent of the patients were younger than age 5 years. Hand-foot-and-mouth syndrome occurred in 79% of the children and central nervous system (CNS) involvement in 35%, including nine fatal cases. The predominant neurological presentations were myoclonus (68%), vomiting (53%), and ataxia (35%). Brain stem encephalitis was the cardinal feature of EV71 CNS involvement during this outbreak. Magnetic resonance imaging and pathological findings illustrated that the midbrain, pens, and medulla were the target areas. EV71 brain stem encephalitis can present either with cerebellar signs and an initially mild, reversible course or with overwhelming neurogenic shock and neurogenic pulmonary edema (NPE) resulting in a fatal outcome. Brain stem encephalitis that progressed abruptly to neurogenic shock and NPE was indicative of poor prognosis in this epidemic. Early aggressive treatment and close monitoring of the neurological signs are mandatory to improve the chance of survival.