This case report describes the first known instance of Coxsackie B3 brainstem encephalitis, highlighting the importance of peripheral sampling for diagnosis when CSF is negative.
First Coxsackie B3 brainstem encephalitis recovered fully; extends enteroviral CNS spectrum but leaves diagnostic and management questions open.
Brainstem encephalitis may be a serious complication of enteroviral infection. Mainly due to human enterovirus A71, it has become a real health issue in Asia Oceania. In Europe, infection remains sporadic or causes small epidemics. Here we report an original case of Coxsackie B3 brainstem encephalitis, the first one to the best of our knowledge. A healthy five years old girl developed brainstem involvement signs. Clinical examination showed no fever, normal heart frequency and normal blood pressure. She presented a self-limited divergent squint which lasted 2 hours followed by oculomotor troubles and a right facial palsy. Biological tests performed on cerebrospinal fluid were not informative. The cerebral Magnetic Resonance Imaging was compatible with a rhombencephalitis. She totally recovered one month after this episode.
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Voinçon et al. (2017) studied this question.
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