Acute encephalomyelitis during an outbreak of enterovirus type 71 infection in Taiwan: Report of an autopsy case with pathologic, immunofluorescence, and molecular studies

Chuen Hsueh, Shih Ming Jung, Shin Ru Shih, Tseng Tong Kuo, Wun Ju Shieh, Sherif Zaki, Tzou Yien Lin, Luan Yin Chang, Hsiao Chen Ning, Da Chin Yen

Research output: Contribution to journalArticle

94 Citations (Scopus)

Abstract

We report a fatal case of enterovirus type 71 (EV 71) infection in an 8-year-old girl during a summer outbreak of hand, foot, and mouth disease in 1998 in Taiwan. The clinical course was rapidly progressive, with manifestations of hand, foot, and mouth disease, aseptic meningitis, encephalomyelitis, and pulmonary edema. The patient died 24 hours after admission. Postmortem study revealed extensive inflammation in the meninges and central nervous system and marked pulmonary edema with focal hemorrhage. Brain stem and spinal cord were most severely involved. The inflammatory infiltrates consisted largely of neutrophils involving primarily the gray matter with perivascular lymphocytic curing, and neuronophagia. The lungs and heart showed no evidence of inflammation. EV 71 was isolated from the fresh brain tissues and identified by immunofluorescence method with type-specific EV 71 monoclonal antibody. It was also confirmed by neutralization test and reverse-transcriptase polymerase chain reaction with sequence analysis. The present case was the first example in which EV 71 was demonstrated to be the causative agent of fatal encephalomyelitis during its epidemic in Taiwan.

Original languageEnglish
Pages (from-to)1200-1205
Number of pages6
JournalModern Pathology
Volume13
Issue number11
Publication statusPublished - 2000
Externally publishedYes

Fingerprint

Enterovirus Infections
Encephalomyelitis
Enterovirus
Taiwan
Hand, Foot and Mouth Disease
Fluorescent Antibody Technique
Disease Outbreaks
Autopsy
Pulmonary Edema
Inflammation
Aseptic Meningitis
Meninges
Neutralization Tests
Reverse Transcriptase Polymerase Chain Reaction
Brain Stem
Sequence Analysis
Spinal Cord
Neutrophils
Central Nervous System
Monoclonal Antibodies

Keywords

  • And mouth disease
  • Encephalitis
  • Encephalomyelitis
  • Enterovirus
  • Enterovirus type 71
  • Foot
  • Hand
  • Meningitis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Acute encephalomyelitis during an outbreak of enterovirus type 71 infection in Taiwan : Report of an autopsy case with pathologic, immunofluorescence, and molecular studies. / Hsueh, Chuen; Jung, Shih Ming; Shih, Shin Ru; Kuo, Tseng Tong; Shieh, Wun Ju; Zaki, Sherif; Lin, Tzou Yien; Chang, Luan Yin; Ning, Hsiao Chen; Yen, Da Chin.

In: Modern Pathology, Vol. 13, No. 11, 2000, p. 1200-1205.

Research output: Contribution to journalArticle

Hsueh, C, Jung, SM, Shih, SR, Kuo, TT, Shieh, WJ, Zaki, S, Lin, TY, Chang, LY, Ning, HC & Yen, DC 2000, 'Acute encephalomyelitis during an outbreak of enterovirus type 71 infection in Taiwan: Report of an autopsy case with pathologic, immunofluorescence, and molecular studies', Modern Pathology, vol. 13, no. 11, pp. 1200-1205.
Hsueh, Chuen ; Jung, Shih Ming ; Shih, Shin Ru ; Kuo, Tseng Tong ; Shieh, Wun Ju ; Zaki, Sherif ; Lin, Tzou Yien ; Chang, Luan Yin ; Ning, Hsiao Chen ; Yen, Da Chin. / Acute encephalomyelitis during an outbreak of enterovirus type 71 infection in Taiwan : Report of an autopsy case with pathologic, immunofluorescence, and molecular studies. In: Modern Pathology. 2000 ; Vol. 13, No. 11. pp. 1200-1205.
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