Clinical features and treatment of serious brainstem encephalitis caused by enterovirus 71 infection

LIU Xiao-Jun, LI Wei, ZHANG Yu-Qin, LIU Ya-Min, LIU Li-Zhen

Chinese Journal of Contemporary Pediatrics ›› 2009, Vol. 11 ›› Issue (12) : 967-969.

PDF(1039 KB)
PDF(1039 KB)
Chinese Journal of Contemporary Pediatrics ›› 2009, Vol. 11 ›› Issue (12) : 967-969.
CLINICAL RESEARCH

Clinical features and treatment of serious brainstem encephalitis caused by enterovirus 71 infection

  • LIU Xiao-Jun, LI Wei, ZHANG Yu-Qin, LIU Ya-Min, LIU Li-Zhen
Author information +
History +

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]

Key words

Brainstem encephalitis / Enterovirus 71 / Pulmonary edema / Clinical feature / Treatment / Child

Cite this article

Download Citations
LIU Xiao-Jun, LI Wei, ZHANG Yu-Qin, LIU Ya-Min, LIU Li-Zhen. Clinical features and treatment of serious brainstem encephalitis caused by enterovirus 71 infection[J]. Chinese Journal of Contemporary Pediatrics. 2009, 11(12): 967-969

References

[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.
[3]赵顺英,李兴旺,江载芳.关注小儿重症肠道病毒71型感染[J].中华儿科杂志,2008,46(5):401-403.
[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.
[7]陈贤楠.肠道病毒71型感染诊治实践中的思考[J].中国小儿急救医学杂志,2008,15(2):97-99.
[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.

PDF(1039 KB)

Accesses

Citation

Detail

Sections
Recommended

/