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Left ventricular dysfunction in children with fulminant enterovirus 71 infection: an evaluation of the clinical
Fang-Liang Huang1, Sheng-Ling Jan, Po-Yen Chen
1Department of Pediatrics, Taichung Veterans General Hospital, Taichung, National Yang-Ming University, Taipei, Taiwan, Republic of China.
Insights
Hand, foot, and mouth disease caused by enterovirus 71 can lead to fatal shock syndrome. Rapid death in these cases is linked to severe heart dysfunction (cardiogenic shock), not lung issues.
Area of Science:
- Pediatric Infectious Diseases
- Cardiology
- Virology
Background:
- Enterovirus 71 (EV71) is a significant cause of hand, foot, and mouth disease (HFMD).
- EV71 infections can lead to severe neurological complications and mortality.
- Fulminant shock syndrome is a rare but devastating complication of EV71 infection.
Observation:
- Two pediatric cases of typical HFMD caused by EV71 are presented.
- Both patients developed acute fulminant shock syndrome.
- Remarkable acute left ventricular dysfunction was observed in both cases.
Findings:
- The fatal outcome in one patient was associated with acute fulminant shock syndrome.
- Severe left ventricular dysfunction was a prominent feature in the affected children.
- The clinical course suggests cardiogenic shock as the primary cause of rapid death.
Implications:
- This highlights the critical role of cardiac dysfunction in EV71-related mortality.
- Distinguishing cardiogenic shock from neurogenic pulmonary edema is crucial for patient management.
- Early recognition and management of cardiac complications may improve outcomes in severe EV71 infections.
Abstract:
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.