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Fatal echovirus type 11 infections
Insights
Fatal echovirus type 11 infections in infants can cause disseminated intravascular coagulation and organ necrosis. A unique case presented with focal myositis beyond the neonatal period.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Pathology
Background:
- Echovirus type 11 (EV-11) infections can lead to severe outcomes in infants.
- Understanding the clinical spectrum and pathological findings of EV-11 is crucial for diagnosis and management.
Observation:
- Two infants presented with fatal EV-11 infections, exhibiting disseminated intravascular coagulation (DIC).
- Postmortem examinations revealed diffuse hemorrhagic necrosis across multiple organ systems, particularly the liver.
- A distinct case involved a 3-month-old infant with lethargy, vomiting, occipital scalp/neck edema, and diffuse EV-11 disease, including focal myositis.
Findings:
- The observed focal myositis in the 3-month-old infant is a unique clinical manifestation of EV-11 disease.
- This case represents the first documented nonparalytic, fatal EV-11 infection occurring outside the immediate neonatal period.
- DIC and hemorrhagic necrosis are significant pathological findings associated with severe EV-11 infection.
Implications:
- These findings highlight the potential severity and varied presentations of EV-11 in infants.
- Early recognition of EV-11 symptoms and prompt diagnostic evaluation are critical.
- Further research into EV-11 pathogenesis and treatment strategies is warranted.
Abstract:
Two infants with fatal echovirus type 11 infections are described. Disseminated intravascular coagulation developed in both patients, and at postmortem examination, diffuse hemorrhagic necrosis of multiple organ systems was evident, most strikingly in the liver. A 3-month-old child is described, in whom lethargy, vomiting, pitting edema of the occipital scalp and neck, and subsequent diffuse echovirus disease developed. The clinical manifestation in this infant of focal myositis with histologic documentation at postmortem examination is unique to echovirus 11 disease. To our knowledge, this child represents the first described patient with nonparalytic, fatal echovirus type 11 infection occurring beyond the immediate neonatal period.