J Korean Child Neurol Soc.  2017 Dec;25(4):255-260. 10.26815/jkcns.2017.25.4.255.

Neurologic Manifestations according to Serotypes of Enterovirus in Pediatric Inpatient in Incheon

• Kim KY
• Park JS
• Kwon MJ
• Kim KS
• Kwon YS

• KMID: 2403729
• DOI: http://doi.org/10.26815/jkcns.2017.25.4.255

Abstract

PURPOSE
Enterovirus infection in children can manifest various disease and enterovirus have many serotypes. This study was aimed to investigate neurologic manifestations according to serotypes of enterovirus in pediatric inpatients in Incheon.
METHODS
We collected the stool samples from the admitted pediatric patients in Inha University Hospital from January 2015 to September 2016. Enterovirus detection and serotypes identification were performed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) and semi-nested RT-PCR.
RESULTS
A total of 527 samples were collected during study period and 170 patients (32.2%) were diagnosed with enterovirus infections. Genetic sequences of enteroviruses were identified: echovirus 18 (50, 40.5%), enterovirus 71 (12, 9.6%), coxakievirus A10 (10, 8.0%), echovirus 6 (7, 5.6%). Virus in patient with meningitis were identified: echovirus 18 (15, 75%), coxakievirus B5 (2, 10%), enterovirus 71 (2, 10%), and echovirus 6 (1, 5%). Neurologic manifestations of echovirus 18 are headache (15, 30%), vomiting (17, 34%), meningeal irritation sign (10, 20.0%). And enterovirus 71 have headache (3, 25%), vomiting (3, 25%), meningeal irritation sign (2, 16.0%), seizure (1, 8.3%), neurologic sequelae (1, 8.3%). Echovirus 18 and neurologic manifestation have a statistically significant correlation with other serotypes (r=0.701, P < 0.01)
CONCLUSION
Echovirus 18 infection was more prominent in neurological symptoms than in other serotypes. The major serotype of meningitis was echovirus 18 but there was no reported neurologic sequelae. Enterovirus infection has different neurological symptoms, depending on the serotypes.

Keyword

Enterovirus; Echovirus; Neurologic manifestation; Meningitis

MeSH Terms

Child
Echovirus 6, Human
Enterovirus B, Human
Enterovirus Infections
Enterovirus*
Headache
Humans
Incheon*
Inpatients*
Meningitis
Neurologic Manifestations*
Reverse Transcriptase Polymerase Chain Reaction
Seizures
Serogroup*
Vomiting