Clinical features of coxsackievirus A4, B3 and B4 infections in children

Chia Jie Lee, Yhu Chering Huang, Shuan Yang, Kuo Chien Tsao, Chih Jung Chen, Yu Chia Hsieh, Cheng Hsun Chiu, Tzou Yien Lin

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Clinical features of coxsackievirus A4 (CA4), B3 (CB3) and B4 (CB4) infections in children have not been comprehensively described. Methods/Principal Findings: From January 2004 to June 2012, a total of 386 children with culture-proven CA4, CB3 and CB4 infections treated at Chang Gung Memorial Hospital, including 296 inpatients (CA4, 103; CB3, 131; CB4, 62) and 90 outpatients (CA4, 55; CB3, 14; CB4, 21), were included. From outpatients, only demographics were extracted and from inpatients, detailed clinical and laboratory data were collected retrospectively. The mean age was 32.1±30.2 months; male to female ratio was 1.3:1. Children with CB3 infection were youngest (76.6% <3 years of age), and had a highest hospitalization rate (90.3%) and a longest duration of hospitalization (mean ± SD, 7.5±6.2 days). Herpangina (74.8%) was the most common presentation for children with CA4 infection, aseptic meningitis (26.7%) and young infant with fever (23.7%) for those with CB3 infection, and herpangina (32.3%) and tonsillitis/pharyngitis (27.4%) for children with CB4 infection. Almost all the inpatients had fever (97.6%). Twelve out of thirteen (92.3%) children with complications and ten of 11 children with long-term sequelae had CB3 infections. Two fatal cases were noted, one due to myocarditis with CA4 infection and CB3 were detected from the other case which had hepatic necrosis with coagulopathy. The remaining 285 children (96.3%) recovered uneventfully. Conclusion: CA4, CB3 and CB4 infections in children had different clinical disease spectrums and involved different age groups. Though rare, severe diseases may occur, particularly caused by CB3.

Original languageEnglish
Article numbere87391
JournalPLoS One
Volume9
Issue number2
DOIs
Publication statusPublished - Feb 4 2014
Externally publishedYes

Fingerprint

Enterovirus
Infection
infection
Herpangina
Coxsackievirus Infections
Inpatients
fever
Hospitalization
Fever
Outpatients
Aseptic Meningitis
Tonsillitis
myocarditis
Pharyngitis
complications (disease)
meningitis
Myocarditis
Rare Diseases
necrosis
Necrosis

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Lee, C. J., Huang, Y. C., Yang, S., Tsao, K. C., Chen, C. J., Hsieh, Y. C., ... Lin, T. Y. (2014). Clinical features of coxsackievirus A4, B3 and B4 infections in children. PLoS One, 9(2), [e87391]. https://doi.org/10.1371/journal.pone.0087391

Clinical features of coxsackievirus A4, B3 and B4 infections in children. / Lee, Chia Jie; Huang, Yhu Chering; Yang, Shuan; Tsao, Kuo Chien; Chen, Chih Jung; Hsieh, Yu Chia; Chiu, Cheng Hsun; Lin, Tzou Yien.

In: PLoS One, Vol. 9, No. 2, e87391, 04.02.2014.

Research output: Contribution to journalArticle

Lee, CJ, Huang, YC, Yang, S, Tsao, KC, Chen, CJ, Hsieh, YC, Chiu, CH & Lin, TY 2014, 'Clinical features of coxsackievirus A4, B3 and B4 infections in children', PLoS One, vol. 9, no. 2, e87391. https://doi.org/10.1371/journal.pone.0087391
Lee CJ, Huang YC, Yang S, Tsao KC, Chen CJ, Hsieh YC et al. Clinical features of coxsackievirus A4, B3 and B4 infections in children. PLoS One. 2014 Feb 4;9(2). e87391. https://doi.org/10.1371/journal.pone.0087391
Lee, Chia Jie ; Huang, Yhu Chering ; Yang, Shuan ; Tsao, Kuo Chien ; Chen, Chih Jung ; Hsieh, Yu Chia ; Chiu, Cheng Hsun ; Lin, Tzou Yien. / Clinical features of coxsackievirus A4, B3 and B4 infections in children. In: PLoS One. 2014 ; Vol. 9, No. 2.
@article{a86e8f754cfd4d2e9faa2d10c97a92a3,
title = "Clinical features of coxsackievirus A4, B3 and B4 infections in children",
abstract = "Background: Clinical features of coxsackievirus A4 (CA4), B3 (CB3) and B4 (CB4) infections in children have not been comprehensively described. Methods/Principal Findings: From January 2004 to June 2012, a total of 386 children with culture-proven CA4, CB3 and CB4 infections treated at Chang Gung Memorial Hospital, including 296 inpatients (CA4, 103; CB3, 131; CB4, 62) and 90 outpatients (CA4, 55; CB3, 14; CB4, 21), were included. From outpatients, only demographics were extracted and from inpatients, detailed clinical and laboratory data were collected retrospectively. The mean age was 32.1±30.2 months; male to female ratio was 1.3:1. Children with CB3 infection were youngest (76.6{\%} <3 years of age), and had a highest hospitalization rate (90.3{\%}) and a longest duration of hospitalization (mean ± SD, 7.5±6.2 days). Herpangina (74.8{\%}) was the most common presentation for children with CA4 infection, aseptic meningitis (26.7{\%}) and young infant with fever (23.7{\%}) for those with CB3 infection, and herpangina (32.3{\%}) and tonsillitis/pharyngitis (27.4{\%}) for children with CB4 infection. Almost all the inpatients had fever (97.6{\%}). Twelve out of thirteen (92.3{\%}) children with complications and ten of 11 children with long-term sequelae had CB3 infections. Two fatal cases were noted, one due to myocarditis with CA4 infection and CB3 were detected from the other case which had hepatic necrosis with coagulopathy. The remaining 285 children (96.3{\%}) recovered uneventfully. Conclusion: CA4, CB3 and CB4 infections in children had different clinical disease spectrums and involved different age groups. Though rare, severe diseases may occur, particularly caused by CB3.",
author = "Lee, {Chia Jie} and Huang, {Yhu Chering} and Shuan Yang and Tsao, {Kuo Chien} and Chen, {Chih Jung} and Hsieh, {Yu Chia} and Chiu, {Cheng Hsun} and Lin, {Tzou Yien}",
year = "2014",
month = "2",
day = "4",
doi = "10.1371/journal.pone.0087391",
language = "English",
volume = "9",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "2",

}

TY - JOUR

T1 - Clinical features of coxsackievirus A4, B3 and B4 infections in children

AU - Lee, Chia Jie

AU - Huang, Yhu Chering

AU - Yang, Shuan

AU - Tsao, Kuo Chien

AU - Chen, Chih Jung

AU - Hsieh, Yu Chia

AU - Chiu, Cheng Hsun

AU - Lin, Tzou Yien

PY - 2014/2/4

Y1 - 2014/2/4

N2 - Background: Clinical features of coxsackievirus A4 (CA4), B3 (CB3) and B4 (CB4) infections in children have not been comprehensively described. Methods/Principal Findings: From January 2004 to June 2012, a total of 386 children with culture-proven CA4, CB3 and CB4 infections treated at Chang Gung Memorial Hospital, including 296 inpatients (CA4, 103; CB3, 131; CB4, 62) and 90 outpatients (CA4, 55; CB3, 14; CB4, 21), were included. From outpatients, only demographics were extracted and from inpatients, detailed clinical and laboratory data were collected retrospectively. The mean age was 32.1±30.2 months; male to female ratio was 1.3:1. Children with CB3 infection were youngest (76.6% <3 years of age), and had a highest hospitalization rate (90.3%) and a longest duration of hospitalization (mean ± SD, 7.5±6.2 days). Herpangina (74.8%) was the most common presentation for children with CA4 infection, aseptic meningitis (26.7%) and young infant with fever (23.7%) for those with CB3 infection, and herpangina (32.3%) and tonsillitis/pharyngitis (27.4%) for children with CB4 infection. Almost all the inpatients had fever (97.6%). Twelve out of thirteen (92.3%) children with complications and ten of 11 children with long-term sequelae had CB3 infections. Two fatal cases were noted, one due to myocarditis with CA4 infection and CB3 were detected from the other case which had hepatic necrosis with coagulopathy. The remaining 285 children (96.3%) recovered uneventfully. Conclusion: CA4, CB3 and CB4 infections in children had different clinical disease spectrums and involved different age groups. Though rare, severe diseases may occur, particularly caused by CB3.

AB - Background: Clinical features of coxsackievirus A4 (CA4), B3 (CB3) and B4 (CB4) infections in children have not been comprehensively described. Methods/Principal Findings: From January 2004 to June 2012, a total of 386 children with culture-proven CA4, CB3 and CB4 infections treated at Chang Gung Memorial Hospital, including 296 inpatients (CA4, 103; CB3, 131; CB4, 62) and 90 outpatients (CA4, 55; CB3, 14; CB4, 21), were included. From outpatients, only demographics were extracted and from inpatients, detailed clinical and laboratory data were collected retrospectively. The mean age was 32.1±30.2 months; male to female ratio was 1.3:1. Children with CB3 infection were youngest (76.6% <3 years of age), and had a highest hospitalization rate (90.3%) and a longest duration of hospitalization (mean ± SD, 7.5±6.2 days). Herpangina (74.8%) was the most common presentation for children with CA4 infection, aseptic meningitis (26.7%) and young infant with fever (23.7%) for those with CB3 infection, and herpangina (32.3%) and tonsillitis/pharyngitis (27.4%) for children with CB4 infection. Almost all the inpatients had fever (97.6%). Twelve out of thirteen (92.3%) children with complications and ten of 11 children with long-term sequelae had CB3 infections. Two fatal cases were noted, one due to myocarditis with CA4 infection and CB3 were detected from the other case which had hepatic necrosis with coagulopathy. The remaining 285 children (96.3%) recovered uneventfully. Conclusion: CA4, CB3 and CB4 infections in children had different clinical disease spectrums and involved different age groups. Though rare, severe diseases may occur, particularly caused by CB3.

UR - http://www.scopus.com/inward/record.url?scp=84895083486&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84895083486&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0087391

DO - 10.1371/journal.pone.0087391

M3 - Article

VL - 9

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 2

M1 - e87391

ER -