LIU CC, WANG SM, YANG HB, SU IJ, YEH TF; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 444 (abstract no. 1969).
Natl. Cheng Kung Univ. Med. Coll. and Hosp., Tainan, TAIWAN REPUBLIC OF CHINA.
BACKGROUND: An outbreak of enterovirus 71 (EV71) infection occurred in Taiwan in 1998. The striking feature of this outbreak was involvement of the Central Nervous System (CNS), including more than 75 fatal cases, complicated with neurogenic pulmonary edema (NPE). OBJECTIVE: To characterize the spectrum of fatal EV71 hand-foot-mouth syndrome, delineate the radiological and pathological correlates, and implicate the possible pathogenesis of pulmonary edema.METHODS: From April 1998 through February 1999, the clinical, laboratory, radiological and pathological findings concerning 10 consecutive children who had catastrophic fatal EV71 infections were retrospectively reviewed. Etiological diagnosis was made by viral cultures and identified by immunofluorescence tests and neutralization tests.RESULTS: Children below five years of age were the chief victims. All had a fulminant course of encephalitis complicated by NPE. EV71 was isolated from throat, stool, aspirates and central nervous system tissue cultures. Postmortem magnetic resonance image studies revealed hyperintensity over posterior pons, medulla and spinal cord. The pathological findings of the one autopsy case illustrated marked neuron necrosis over tegmentum of brain stem area and gray matter of spinal cord.CONCLUSIONS: The symptomatology, the neuroimage and the neuropathological findings consist with an ongoing rostrol-caudal inflammatory reaction along the tegmentum of brain stem areas to the spinal cord being responsible for the fatal EV71 encephalitis in our patients.
Publication Types:
Keywords:
- Biomedical Research
- Brain Stem
- Child
- Disease Outbreaks
- Encephalitis
- Encephalitis, Viral
- Encephalomyelitis
- Enterovirus
- Enterovirus Infections
- Humans
- Neurons
- Pulmonary Edema
- Spinal Cord
- Taiwan
- Tegmentum Mesencephali
Other ID:
UI: 102245631
From Meeting Abstracts