Clinical features of coxsackievirus A4, B3 and B4 infections in children.
Clinical features of coxsackievirus A4, B3 and B4 infections in children.
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DOI：
10.1371/journal.pone.0087391
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Lin TY
中科院分区：
文献类型：
--
作者：
Lee CJ;Huang YC;Yang S;Tsao KC;Chen CJ;Hsieh YC;Chiu CH;Lin TY
柯萨奇病毒A4（CA 4）、B3（CB 3）和B4（CB 4）感染儿童的临床特征尚未得到全面描述。从2004年1月至2012年6月，共有386名经培养证实为CA 4、CB 3和CB 4感染的儿童在长庚医院接受治疗，包括296名住院患者（CA 4，103; CB 3，131; CB 4，62）和90名门诊患者（CA 4，55; CB 3，14; CB 4，21）。从门诊患者中，仅提取人口统计学资料，从住院患者中，回顾性收集详细的临床和实验室数据。平均年龄32.1±30.2个月，男女之比为1.3∶1. CB 3感染患儿年龄最小（76.6% <3岁），住院率最高（90.3%），住院时间最长（平均值±标准差，7.5±6.2天）。CA 4感染患儿以疱疹性咽峡炎（74.8%）最常见，CB 3感染患儿以无菌性脑膜炎（26.7%）和婴幼儿发热（23.7%）最常见，CB 4感染患儿以疱疹性咽峡炎（32.3%）和扁桃体炎/咽炎（27.4%）最常见。住院患者发热占97.6%。12/13例（92.3%）并发症患儿和10/11例长期后遗症患儿有CB 3感染。观察到2例致死性病例，1例因心肌炎伴CA 4感染，另1例因肝坏死伴凝血功能障碍检测到CB 3。其余285名儿童（96.3%）恢复顺利。儿童CA 4、CB 3、CB 4感染的临床疾病谱不同，涉及不同年龄组。虽然罕见，但也可能发生严重的疾病，特别是由CB 3引起的疾病。
Clinical features of coxsackievirus A4 (CA4), B3 (CB3) and B4 (CB4) infections in children have not been comprehensively described. From January 2004 to June 2012, a total of 386 children with culture-proven CA4, CB3 and CB4 infections treated at Chang Gung Memorial Hospital, including 296 inpatients (CA4, 103; CB3, 131; CB4, 62) and 90 outpatients (CA4, 55; CB3, 14; CB4, 21), were included. From outpatients, only demographics were extracted and from inpatients, detailed clinical and laboratory data were collected retrospectively. The mean age was 32.1±30.2 months; male to female ratio was 1.3∶1. Children with CB3 infection were youngest (76.6% <3 years of age), and had a highest hospitalization rate (90.3%) and a longest duration of hospitalization (mean ± SD, 7.5±6.2 days). Herpangina (74.8%) was the most common presentation for children with CA4 infection, aseptic meningitis (26.7%) and young infant with fever (23.7%) for those with CB3 infection, and herpangina (32.3%) and tonsillitis/pharyngitis (27.4%) for children with CB4 infection. Almost all the inpatients had fever (97.6%). Twelve out of thirteen (92.3%) children with complications and ten of 11 children with long-term sequelae had CB3 infections. Two fatal cases were noted, one due to myocarditis with CA4 infection and CB3 were detected from the other case which had hepatic necrosis with coagulopathy. The remaining 285 children (96.3%) recovered uneventfully. CA4, CB3 and CB4 infections in children had different clinical disease spectrums and involved different age groups. Though rare, severe diseases may occur, particularly caused by CB3.
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