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Published on: December 10, 2013
Clinical features of echovirus 6 and 9 infections in children
Hao-Yuan Lee1, Chih-Jung Chen, Yhu-Chering Huang
1Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Insights
Clinical features of echovirus 6 and 9 infections in children were evaluated. Aseptic meningitis was most common, but rare severe outcomes like death or seizures can occur in hospitalized children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Clinical manifestations of echovirus 6 and 9 infections in children, especially sporadic cases, require further evaluation.
- Understanding these features is crucial for timely diagnosis and management.
Purpose of the Study:
- To comprehensively describe the clinical spectrum of echovirus 6 and 9 infections in pediatric patients.
- To identify differences in clinical presentation and outcomes between echovirus 6 and 9 infections.
Main Methods:
- A retrospective analysis of 199 children with culture-proven echovirus 6 or 9 infections from 2000-2008.
- Detailed data extraction and analysis focused on 174 hospitalized children.
Main Results:
- Aseptic meningitis was the most frequent diagnosis for both echovirus 6 (49%) and 9 (51%) infections.
- Echovirus 9 infections were associated with longer fever duration (6.0 vs. 3.8 days) and echovirus 6 with higher leukocytosis rates.
- While most children recovered, rare severe outcomes including death and seizure disorders were observed.
Conclusions:
- Aseptic meningitis is the predominant clinical presentation for hospitalized children with echovirus 6 or 9 infections.
- Although uncommon, severe complications such as mortality and long-term neurological sequelae can occur.
- This study highlights the importance of recognizing the diverse clinical spectrum of these viral infections in children.
Background:
Clinical features of echovirus 6 and 9 infections in children have not been comprehensively evaluated, particularly for sporadic cases.
Objective:
To describe the clinical features of children with echovirus 6 or 9 infections.
Study Designs:
From 2000 to 2008, 199 children with culture-proven echovirus 6 or 9 infections identified in a university-affiliated hospital were included. Data extracted from 174 inpatients were further analyzed.
Results:
Age ranged from 4 days to 15 years with a mean of 4.7 years. 123 (62%) were male. The disease spectrums were similar for echovirus 6 (n=100) and 9 (n=74) infections, with aseptic meningitis (49% and 51%, respectively) being the most common syndrome, followed by meningismus, upper respiratory tract infection, pneumonia, and herpangina. All 174 inpatients had fever but the duration of fever was significantly longer in patient with echovirus 9 infection than those with echovirus 6 infections (6.0 days vs. 3.8 days, p<0.001). The rate of leukocytosis (leukocyte count>15,000/μL) were significantly higher in patients with echovirus 6 infections than those with echovirus 9 infection (p<0.001). One neonate with echovirus 6 infection died from hepatic necrosis with coagulopathy, and one infant with echovirus 6 infection and one child with echovirus 9 infection died from brain involvement. Two children had long-term sequelae of seizure disorder. The remaining 169 children (97%) recovered uneventfully.
Conclusion:
For children with echovirus 6 or 9 infections requiring hospitalization, aseptic meningitis was the most common manifestation and fatal outcome or long-term sequel, though rare, might occur.
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