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Related Concept Videos

Poliomyelitis01:17

Poliomyelitis

Poliomyelitis is caused by poliovirus, a small, non-enveloped, positive-sense RNA virus of the Picornaviridae family and Enterovirus genus. Transmission occurs primarily via the fecal-oral route, often through ingestion of contaminated water or food. The virus initially replicates in the oropharynx and intestinal mucosa, particularly in lymphoid tissues such as the tonsils, Peyer’s patches, and regional lymph nodes. Primary viremia follows, allowing dissemination throughout the body.In most...
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Respiratory Syncytial Virus Disease

Human respiratory syncytial virus (RSV) is a widespread pathogen that primarily targets infants and young children but also poses a serious health risk to elderly and immunocompromised individuals. Belonging to the Pneumoviridae family, RSV is a negative-sense, single-stranded RNA virus within the Pneumovirus genus. Its global health burden is significant, with millions of cases annually resulting in hospitalizations and mortality, particularly in resource-limited settings. Although most...
Viral Meningitis01:18

Viral Meningitis

Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
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Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
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Enhance airway patency
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Encephalitis ll: Pathophysiology01:26

Encephalitis ll: Pathophysiology

Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
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Assays for the Specific Growth Rate and Cell-binding Ability of Rotavirus
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Published on: January 28, 2019

Enterovirus 71: epidemiology, pathogenesis and management.

Shih-Min Wang1, Ching-Chuan Liu

  • 1Department of Emergency Medicine, College of Medicine, National Cheng Kung University and Hospital, 138 Sheng Li Road, Tainan, 70428, Taiwan. pedwang@mail.ncku.edu.tw

Expert Review of Anti-Infective Therapy
|August 18, 2009
PubMed
Summary

Enterovirus 71 (EV71) causes severe neurological disease and high mortality, especially in young children. Treatment with intravenous IgG and milrinone may reduce mortality by managing autonomic dysfunction and inflammation.

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Area of Science:

  • Virology
  • Neurology
  • Critical Care Medicine

Background:

  • Enterovirus 71 (EV71) is a significant global neurological threat post-poliovirus eradication.
  • EV71 infections range from mild hand-foot-mouth disease to severe brainstem encephalitis with acute flaccid paralysis.
  • High mortality rates are observed in EV71 brainstem encephalitis, particularly in children under five, often due to pulmonary edema.

Purpose of the Study:

  • To investigate the mechanism of EV71-induced autonomic nervous system dysregulation and pulmonary edema.
  • To evaluate the efficacy of intravenous IgG and milrinone in treating severe EV71 brainstem encephalitis.

Main Methods:

  • The study examines the destruction of brainstem vasomotor centers by EV71.
  • It analyzes the role of cytokine and chemokine release in systemic inflammatory response syndrome (SIRS) and pulmonary vascular permeability.
  • Treatment outcomes for patients receiving intravenous IgG and milrinone were assessed.

Main Results:

  • EV71 infection leads to autonomic nervous system dysregulation through brainstem lesions.
  • Pulmonary edema results from increased pulmonary vascular permeability, triggered by direct brainstem damage and/or SIRS.
  • Treatment with intravenous IgG and milrinone demonstrated significantly decreased mortality in severe EV71 brainstem encephalitis cases.
  • This therapeutic approach attenuated sympathetic activity and reduced cytokine production.

Conclusions:

  • EV71 poses a critical threat, causing neurological complications and high mortality.
  • Autonomic dysregulation and pulmonary edema are key pathological features.
  • Intravenous IgG and milrinone offer a promising therapeutic strategy for severe EV71 infections, reducing mortality by modulating the host response.