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Echovirus 7 associated encephalomyelitis.

Lucy Chai See Lum1, Kaw Bing Chua, Peter Charles McMinn

  • 1Department of Pediatrics, University of Malaya Medical Center, 50603, Kuala Lumpur, Malaysia. lumcs@medicine.med.um.edu.my

Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology
|October 12, 2001
PubMed
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Echovirus 7 infection can cause fatal encephalomyelitis with severe heart dysfunction. This study identified Echovirus 7 as the cause in children with neurological and cardiac symptoms, including one with hand, foot, and mouth disease.

Area of Science:

  • Virology
  • Neurology
  • Cardiology

Background:

  • Hand, foot, and mouth disease (HFMD) is endemic in Malaysia, with past outbreaks linked to Enterovirus 71 (EV-71).
  • Previous severe HFMD outbreaks caused fatalities due to cardiac and central nervous system damage.

Observation:

  • Three children presented with acute encephalomyelitis, two fatally, and one with central nervous system infection.
  • Clinical presentations included rapid cardio-respiratory decompensation and cardiac arrest in fatal cases.

Findings:

  • Echovirus 7 was identified as the causative agent in all three cases of acute encephalomyelitis.
  • Fatal cases exhibited severe left ventricular dysfunction resistant to treatment.
  • The survivor experienced residual bulbar palsy but had a good neurological outcome.

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Implications:

  • Echovirus 7 infection can lead to fatal encephalomyelitis through indirect cardiac involvement and severe left ventricular dysfunction.
  • This is the first reported association of Echovirus 7 with the hand, foot, and mouth disease syndrome.