Abstract：OBJECTIVE: To study the clinical features and treatment of serious brainstem encephalitis caused by enterovirus 71 (EV71) infection. METHODS: The clinical data of 32 hospitalized children with serious brainstem encephalitis caused by EV71 infection between May and December 2008 were retrospectively reviewed. RESULTS: The children whose age was younger than 3 years old accounted for 88% (22 cases). Fever (>38.5℃) lasting at least 3 days, frequent vomiting and limb twitch were presented as the main manifestations in the 32 children. Cyanosis, tachypnea, tachycardia and cold extremities were observed, and pulmonary edema or even pulmonary hemorrhage occurred in 8 children 3 to 4 days after the onset. The 32 children received a medical treatment: reduction of intracranial pressure with mannitol or frusemide, inhibition of inflammation reactivity with gamma globulin and methylprednisolone, and improvement of cardiac function and pulmonary edema with innotropic agents, fluid restriction and positive mechanical ventilation. CONCLUSIONS: Vegetative nerve functional disturbance is the main clinical feature of brainstem encephalitis caused by EV71 infection in children. An early identification and treatment of pulmonary edema or hemorrhage is of great importance.［Chin J Contemp Pediatr, 2009, 11 (12):967-969］
LIU Xiao-Jun,LI Wei,ZHANG Yu-Qin et al. Clinical features and treatment of serious brainstem encephalitis caused by enterovirus 71 infection[J]. CJCP, 2009, 11(12): 967-969.
［1］McMinn P, Stratov I, Nagarajan L, Davis S. Neurological manifestations of enterovirus 71 infection in children during an outbreak of hand, foot, and mouth disease in western australia［J］.Clin Infect Dis, 2001, 32（2）:236-242.
［2］Kao SJ, Yang FL, Hsu YH, Chen HL. Mechanism of fulminant pulmonary edema caused by enterovirus 71［J］. Clin Infect Dis, 2004, 38(12):1784-1788.
［4］Arya SC. Antiviral therapy for neurological manifestations of enterovirus 71 infection［J］. Clin Infect Dis, 2000, 30（6）:988-992.
［5］Rotbart HA, O'Connell JF, McKinlay MA. Treatment of human enterovirus infections［J］. Antiviral Res, 1998, 38（1）:1-14.
［6］Wang SM, Lei HY, Huang KJ, Wu JM, Wang JR, Yu CK, et al. Pathogenesis of enterovirus 71 brainstem encephalitis in pediatric patients: roles of cytokines and cellular immune activation in patients with pulmonary edema［J］. J Infect Dis, 2003, 188(4):564-570.
［8］Wang JN, Yao CT, Yeh CN, Huang CC, SM. Critical management in patients with severe enterovirus 71 infection［J］. Pediatr Int, 2006, 48(3):250-256.
［9］Wang SM, Lei HY, Huang MC, Wu JM, Chen CT, Wang JN, et al. Therapeutic efficacy of milrinone in the management of enterovirus 71-induced pulmonary edema［J］. Pediatr Pulmonol, 2005, 39（3）:219-223.
