Korean J Pediatr.
2015 Mar;58(3):112-115. 10.3345/kjp.2015.58.3.112.
Massive pulmonary hemorrhage in enterovirus 71-infected hand, foot, and mouth disease
- Affiliations
-
- 1Department of Pediatrics, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea. twsong@paik.ac.kr
- 2Division of Vaccine Research, Center for Infectious Disease, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongwon, Korea.
- KMID: 2149748
- DOI: http://doi.org/10.3345/kjp.2015.58.3.112
Abstract
- Hand, foot, and mouth disease (HFMD) is an acute, mostly self-limiting infection. Patients usually recover without any sequelae. However, a few cases are life threatening, especially those caused by enterovirus 71 (EV71). A 12-month-old boy was admitted to a primary hospital with high fever and vesicular lesions of the mouth, hands, and feet. After 3 days, he experienced 3 seizure episodes and was referred to our hospital. On admission, he was conscious and his chest radiograph was normal. However, 6 hours later, he suddenly lost consciousness and had developed a massive pulmonary hemorrhage that continued until his death. He experienced several more intermittent seizures, and diffuse infiltration of both lung fields was observed on chest radiography. Intravenous immunoglobulin, dexamethasone, cefotaxime, leukocyte-depleted red blood cells, fresh frozen plasma, inotropics, vitamin K, and endotracheal epinephrine were administered. The patient died 9 hours after intubation, within 3 days from fever onset. EV71 subgenotype C4a was isolated retrospectively from serum and nasopharyngeal swab by real-time reverse transcription-polymerase chain reaction. Here, we report a fatal case of EV71-associated HFMD with sudden-onset massive pulmonary hemorrhage and suspected encephalitis.
MeSH Terms
-
Cefotaxime
Consciousness
Dexamethasone
Encephalitis
Enterovirus*
Epinephrine
Erythrocytes
Fever
Foot*
Hand*
Hemorrhage*
Humans
Immunoglobulins
Infant
Intubation
Lung
Male
Mouth
Mouth Diseases*
Plasma
Radiography
Radiography, Thoracic
Retrospective Studies
Seizures
Thorax
Vitamin K
Cefotaxime
Dexamethasone
Epinephrine
Immunoglobulins
Vitamin K
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Hand, foot and mouth disease associated with the aseptic meningitis in Seoul, 1990
- Hand Foot Mouth Disease with Meningomyeloencephalitis Caused by Enterovirus 71
- Paralytic Disease Related to Enterovirus 71 Infection: A report of 4 cases
- Two Cases of Hand-Foot-Mouth Disease with Neurologic Manifestations
- Enterovirus 71 Brainstem Encephalitis Presenting with Pulmonary Hemorrhage and Acute Heart Failure
