Clinical features and risk factors of pulmonary oedema after enterovirus-71-related hand, foot, and mouth disease

Luan Yin Chang, Tzou Yien Lin, Kuang Hung Hsu, Yhu Chering Huang, Kuang Lin Lin, Chuen Hsueh, Shin Ru Shih, Hsiao Chen Ning, Mao Sheng Hwang, Huei Shyoung Wang, Chin Yun Lee

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342 引文 斯高帕斯(Scopus)

摘要

Background. In Taiwan, from April to July, 1998, an epidemic of hand, foot, and mouth disease associated with enterovirus 71 (EV71) occurred with fatal complications. We did a clinical study of EV71-related diseases in Taiwan. Methods. We studied 154 children with virus-culture-confirmed EV71 infection. Children were divided into three groups: 11 patients with pulmonary oedema; 38 patients with central nervous system (CNS) involvement and no pulmonary oedema; and 105 children without complications. We compared the clinical features, laboratory findings, risk factors, and outcome among these three groups. Findings. Nine children with pulmonary oedema had hand, foot, and mouth disease, one had herpangina, and one had febrile illness with eight children with limb weakness and one with limb hypesthesia. All children had had sudden onset of tachycardia, tachypnoea, and cyanosis 1-3 days after onset of the disease. Nine of 11 children died within 12 h of intubation; one child was braindead within 15 h and died 17 days after intubation; one child was in deep coma and died 3 months later. In children with CNS complication and no pulmonary oedema, one child died of pneumonia after 4 months of ventilator support and four children had sequelae. All 105 children without complications recovered. There was a significant association between CNS involvement and pulmonary oedema (odds ratio 12.4 [95% CI 2.6-60.1], p = 0.001). Risk factors for pulmonary oedema after CNS involvement were hyperglycaemia, leucocytosis, and limb weakness. Hyperglycaemia was the most significant prognostic factor for pulmonary oedema (odds ratio 21.5 [3-159], p = 0.003). Interpretation. EV71 can cause hand, foot, and mouth disease, CNS involvement with severe sequelae, and fatal pulmonary oedema. Hyperglycaemia is the most important prognostic factor.
原文英語
頁(從 - 到)1682-1686
頁數5
期刊Lancet
354
發行號9191
DOIs
出版狀態已發佈 - 十一月 13 1999
對外發佈

ASJC Scopus subject areas

  • 醫藥 (全部)

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