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Related Concept Videos

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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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Milrinone in Enterovirus 71 Brain Stem Encephalitis.

Shih-Min Wang1

  • 1Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainan, Taiwan; Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainan, Taiwan; Center of Infectious Disease and Signaling Research, National Cheng Kung UniversityTainan, Taiwan.

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Enterovirus 71 (EV71) infection can cause fatal pulmonary edema. Milrinone, a phosphodiesterase inhibitor, effectively treats this complication by reducing inflammation and improving survival in patients with EV71-associated disease.

Keywords:
Enterovirus 71brain stem encephalitisinflammationmilrinonepulmonary edema

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Area of Science:

  • Virology
  • Cardiology
  • Immunology

Background:

  • Enterovirus 71 (EV71) outbreaks have been widespread in the Asia Pacific since 1997, causing hand-foot-and-mouth disease (HFMD).
  • EV71 infection can lead to severe complications, including neurogenic shock with pulmonary edema (PE), a potentially fatal condition.
  • The immunopathogenesis of EV71-induced PE necessitates targeted therapeutic interventions.

Purpose of the Study:

  • To evaluate the efficacy of milrinone as a therapeutic agent for EV71-induced pulmonary edema.
  • To investigate the mechanisms by which milrinone modulates the inflammatory response in severe EV71 infection.

Main Methods:

  • Milrinone, a type III phosphodiesterase inhibitor with inotropic and vasodilator effects, was selected for therapeutic use.
  • The study assessed clinical efficacy by observing modulation of inflammation and sympathetic over-activity.

Main Results:

  • Milrinone demonstrated clinical efficacy in improving survival rates in patients with EV71-associated PE.
  • The drug was effective in modulating inflammation and reducing sympathetic over-activity.
  • Milrinone exhibits significant immunoregulatory and anti-inflammatory effects.

Conclusions:

  • Milrinone is a valuable therapeutic agent for managing EV71-induced pulmonary edema.
  • Its immunomodulatory and anti-inflammatory properties are crucial in treating severe EV71 infections.
  • Milrinone improves outcomes in patients suffering from EV71-associated critical illness.