Key result
Severe EV-A71 infection in children commonly presented with fever (93.1%), irritability (69.3%), and lethargy (55.4%), with abnormal neurological MRI findings in 59.3% of evaluated patients.
Why the study?
There are few reports on the timing of onset and symptoms of enterovirus A71 infection, which can easily be misdiagnosed, leading the authors to explore clinical characteristics in severe pediatric cases.
Observational (n=101)
No
Severe EV-A71 infection in children frequently presents with fever, irritability, lethargy, and abnormal neurological MRI findings.
May aid recognition of severe pediatric EV-A71 via fever, irritability, and lethargy; leaves open prospective validation of MRI and CSF correlations.
BACKGROUND: There are few reports on the timing of onset and the symptoms of enterovirus A71 (EV-A71) infection, which can easily be misdiagnosed. This study aimed to explore the clinical characteristics of children with severe EV-A71 infection. METHODS: This retrospective observational study included children with severe EV-A71 infection admitted to Hebei Children's Hospital between January 2016 and January 2018. RESULTS: A total of 101 patients were included: 57 males (56.4%) and 44 females (43.6%). They were 1-13 years of age. The symptoms were fever in 94 patients (93.1%), rash in 46 (45.5%), irritability in 70 (69.3%), and lethargy in 56 (55.4%). There were 19 (59.3%) patients with abnormal neurological magnetic resonance imaging [pontine tegmentum (n = 14, 43.8%), medulla oblongata (n = 11, 34.4%), midbrain (n = 9, 28.1%), cerebellum and dentate nucleus (n = 8, 25.0%), basal ganglia (n = 4, 12.5%), cortex (n = 4, 12.5%), spinal cord (n = 3, 9.3%), and meninges (n = 1, 3.1%)]. There was a positive correlation between the ratio of neutrophil count and white blood cell count in cerebrospinal fluid in the first 3 days of the disease (r = 0.415, P < 0.001). CONCLUSION: The clinical symptoms of EV-A71 infection are fever and/or skin rash, irritability, and lethargy. Some patients have abnormal neurological magnetic resonance imaging. The white blood cell count in the cerebrospinal fluid of children with EV-A71 infection may increase alongside neutrophil counts.
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Wu et al. (2023) conducted an observational in Severe enterovirus A71 (EV-A71) infection (n=101). Severe EV-A71 infection was evaluated on Clinical characteristics and MRI findings. Severe EV-A71 infection in children commonly presented with fever (93.1%), irritability (69.3%), and lethargy (55.4%), with abnormal neurological MRI findings in 59.3% of evaluated patients.
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