Fulminant enterovirus 71 infection can cause severe acute left ventricular dysfunction, suggesting that rapid mortality is driven by cardiogenic shock rather than neurogenic pulmonary edema.
Cardiogenic shock may drive rapid mortality in fulminant enterovirus rhombencephalitis; hypothesis-generating from two cases, prospective studies needed.
We describe 2 children with typical hand, foot, and mouth disease due to enterovirus 71 infection, 1 of whom died. Both cases were complicated by acute fulminant shock syndrome; the patients had remarkable acute left ventricular dysfunction. The clinical experience indicates that the rapid death associated with fulminant enterovirus rhombencephalitis is the result of rapid cardiogenic shock rather than neurogenic pulmonary edema.
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Huang et al. (2002) studied this question.
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