Clinical features and emergency management of severe encephalitis and neurogenic pulmonary edema caused by enterovirus type 71 in children
- VernacularTitle:儿童危重肠道病毒71型脑炎及神经源性肺水肿的临床特征与救治
- Author:
Yuncai ZHANG
;
Xingwang LI
;
Xiaodong ZHU
;
Suyun QIAN
;
Jiansheng ZENG
;
Yunxiao SHANG
;
Biru LIU
;
Xiaolin LIU
;
Xiangui RAN
- Publication Type:Journal Article
- Keywords:
Entemvirus 71(EV71);
Encephalitis;
Neurogenic pulmonary edema;
Hand-foot-mouth disease(HFMD);
Child
- From:
Chinese Journal of Emergency Medicine
2008;17(12):1250-1254
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical characteristics and emergency management of severe hand-foot-mouth disease(HFMD)associated with encephalitis and neurogenic pulmonary edema(NPE)caused by en-terovirus 71(EV71)in children.Method Data of critical patients with severe HFMD associated with encephalitis and NPE admitted to pediatric intensive care unit(PICU)Fuyan city Hospitals Anhni Province from May to June 2008 were reviewed.Results Of 30 patients,the mean age was 15.8 months ranged from 4 months to 48 months.The overall morality was 19.4%.Tha average duration of critical symptoms persisted Was 2.1 days ranged from 12 hours to 5 days.There were no rash found in 12 patients(33.3%).The chinical features of nervous system mani-fested the symptoms of brainstem encephalitis in 27 patients(75%),brainstem encephalitis with myelitis in 6 pa-tients(16.7%),and encephalitis in 3 patients(8.3%).The frothy expectoration tinged with pink or bloody,asyrmmetrical pulmonary edema or hemoptysis were the main features of NPE.The main approaches to the treatment were mechanical ventilation,mannitol,methylpredifiselone,intravenous immunoglobulin(IVIG),and vasoactive a-gents.And nine patients(25%)needed fluid volume resuscitation in addition.Conclusions Young children are particularly vulnerable to the Severe EV71 encephalitis with NPE.The majority of involved fatal patients are aged under 3 years.Patients may die of acute onset of NPE and/or hemoptysis with rapid progress towards cardiopul-monary failure.Early diagnosis and evaluation,respiratory support,lowering intracranial pressure and maintaining hemodynamics ale the essential therapeutic approaches.
