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MRI of Enterovirus 71 myelitis with monoplegia
1Department of Radiology, and School of Medicine, China Medical College, China Medical College Hospital, No. 2 Yuh-Der Road, 407 Taichung, Taiwan, Republic of China. wschen@ficnet.net
Abstract:
We report two boys diagnosed as having herpangina and hand-foot-mouth disease complicated by monoplegia during the outbreak enterovirus infection in Taiwan in 1998. Enterovirus 71 was identified in the stool and throat swab; neither polio nor Coxsackie viruses was identified. MRI showed unilateral lesions in the anterior horns of the spinal cord at T11-12 and C2-5. Although the MRI findings and sites of these lesions were similar to those of poliovirus-associated poliomyelitis, the virological data indicated that these boys were infected with enterovirus type 71.
Insights
Enterovirus 71 caused herpangina and hand-foot-mouth disease with monoplegia in two boys. Magnetic resonance imaging revealed spinal cord lesions similar to poliovirus, but virology confirmed enterovirus 71 infection.
Area of Science:
- Neurology
- Virology
- Infectious Diseases
Background:
- Herpangina and hand-foot-mouth disease are common childhood illnesses often caused by enteroviruses.
- Poliomyelitis, caused by poliovirus, can lead to paralysis due to spinal cord lesions.
Observation:
- Two boys presented with herpangina and hand-foot-mouth disease complicated by monoplegia during an enterovirus outbreak in Taiwan.
- Enterovirus 71 was detected in stool and throat samples; poliovirus and Coxsackie viruses were not identified.
Findings:
- Magnetic resonance imaging (MRI) revealed unilateral lesions in the anterior horns of the spinal cord at T11-12 and C2-5.
- Despite MRI findings resembling poliovirus-associated poliomyelitis, etiological investigation confirmed enterovirus 71 as the causative agent.
Implications:
- Enterovirus 71 can cause neurological complications, including monoplegia, mimicking poliovirus infection.
- This highlights the importance of accurate virological diagnostics for differentiating enterovirus 71 infections from poliovirus, especially during outbreaks.