Echovirus 11 infection in infants ≤3 months old was associated with a higher incidence of aseptic meningitis compared to coxsackievirus B5 infection (35% vs 0%, P=0.003).
Observational (n=125)
No
Do clinical manifestations and outcomes differ between echovirus 11 and coxsackievirus B5 infections in hospitalized children?
Echovirus 11 infections in hospitalized children are associated with greater neurological tropism and severity, including aseptic meningitis and acute liver failure, compared to coxsackievirus B5.
Absolute Event Rate: 35% vs 0%
p-value: p=0.003
BACKGROUND: Severe illness can occur in young children infected with certain types of enteroviruses including echovirus 11 (Echo11) and coxsackievirus B5 (CoxB5). The manifestations and outcomes of Echo11 and CoxB5 diseases across all ages of children remained not comprehensively characterized in Taiwan. METHODS: Culture-confirmed Echo11 (60 patients) or CoxB5 (65 patients) infections were identified in a hospital from 2010 to 2018. The demographics, clinical presentations, laboratory data and outcomes were abstracted and compared between the two viruses infections. RESULTS: Echo11 and CoxB5 was respectively identified in 7 (77.8%) and 2 (22.2%) of 9 calendar years. The median age of all patients was 15 months (range, 1 day-14.5 years). For infants ≤3 months old, Echo11 (23 cases) was associated with higher incidence of aseptic meningitis (35% versus 0%, P = 0.003), and a lower rate of upper respiratory tract infections (URI) (22% versus 65%, P = 0.004) compared to CoxB5 (20 cases) infections. For patients >3 months old, URI was the cardinal diagnosis (60%) for both viruses. Aseptic meningitis was also more commonly identified in elder children with Echo11 infections (27% versus 11%), though with marginal significance (P = 0.07). Acute liver failure was identified in four young infants with Echo11 infections including one neonate dying of severe sepsis and myocarditis. All patients with CoxB5 infections recovered uneventfully. CONCLUSION: Aseptic meningitis, sepsis-like illness and acute liver failure were more commonly identified in children with Echo11 than those with CoxB5 infections, suggesting greater neurological tropism and virulence toward Echo11.
Chen et al. (Sat,) conducted a observational in Echovirus 11 or coxsackievirus B5 infection (n=125). Echovirus 11 infection vs. Coxsackievirus B5 infection was evaluated on Aseptic meningitis in infants ≤3 months old (p=0.003). Echovirus 11 infection in infants ≤3 months old was associated with a higher incidence of aseptic meningitis compared to coxsackievirus B5 infection (35% vs 0%, P=0.003).