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Clinical features, diagnosis, and management of enterovirus 71.
Lancet Neurol. 2010 Nov; 9(11):1097-105.LN

Abstract

Although poliomyelitis has been mostly eradicated worldwide, large outbreaks of the related enterovirus 71 have been seen in Asia-Pacific countries in the past 10 years. This virus mostly affects children, manifesting as hand, foot, and mouth disease, aseptic meningitis, poliomyelitis-like acute flaccid paralysis, brainstem encephalitis, and other severe systemic disorders, including especially pulmonary oedema and cardiorespiratory collapse. Clinical predictors of severe disease include high temperature and lethargy, and lumbar puncture might reveal pleocytosis. Many diagnostic tests are available, but PCR of throat swabs and vesicle fluid, if available, is among the most efficient. Features of inflammation, particularly in the anterior horns of the spinal cord, the dorsal pons, and the medulla can be clearly seen on MRI. No established antiviral treatment is available. Intravenous immunoglobulin seems to be beneficial in severe disease, perhaps through non-specific anti-inflammatory mechanisms, but has not been tested in any formal trials. Milrinone might be helpful in patients with cardiac dysfunction.

Authors+Show Affiliations

Institute of Infection and Global Health, University of Liverpool, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

20965438

Citation

Ooi, Mong How, et al. "Clinical Features, Diagnosis, and Management of Enterovirus 71." The Lancet. Neurology, vol. 9, no. 11, 2010, pp. 1097-105.
Ooi MH, Wong SC, Lewthwaite P, et al. Clinical features, diagnosis, and management of enterovirus 71. Lancet Neurol. 2010;9(11):1097-105.
Ooi, M. H., Wong, S. C., Lewthwaite, P., Cardosa, M. J., & Solomon, T. (2010). Clinical features, diagnosis, and management of enterovirus 71. The Lancet. Neurology, 9(11), 1097-105. https://doi.org/10.1016/S1474-4422(10)70209-X
Ooi MH, et al. Clinical Features, Diagnosis, and Management of Enterovirus 71. Lancet Neurol. 2010;9(11):1097-105. PubMed PMID: 20965438.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical features, diagnosis, and management of enterovirus 71. AU - Ooi,Mong How, AU - Wong,See Chang, AU - Lewthwaite,Penny, AU - Cardosa,Mary Jane, AU - Solomon,Tom, PY - 2010/10/23/entrez PY - 2010/10/23/pubmed PY - 2010/11/17/medline SP - 1097 EP - 105 JF - The Lancet. Neurology JO - Lancet Neurol VL - 9 IS - 11 N2 - Although poliomyelitis has been mostly eradicated worldwide, large outbreaks of the related enterovirus 71 have been seen in Asia-Pacific countries in the past 10 years. This virus mostly affects children, manifesting as hand, foot, and mouth disease, aseptic meningitis, poliomyelitis-like acute flaccid paralysis, brainstem encephalitis, and other severe systemic disorders, including especially pulmonary oedema and cardiorespiratory collapse. Clinical predictors of severe disease include high temperature and lethargy, and lumbar puncture might reveal pleocytosis. Many diagnostic tests are available, but PCR of throat swabs and vesicle fluid, if available, is among the most efficient. Features of inflammation, particularly in the anterior horns of the spinal cord, the dorsal pons, and the medulla can be clearly seen on MRI. No established antiviral treatment is available. Intravenous immunoglobulin seems to be beneficial in severe disease, perhaps through non-specific anti-inflammatory mechanisms, but has not been tested in any formal trials. Milrinone might be helpful in patients with cardiac dysfunction. SN - 1474-4465 UR - https://www.unboundmedicine.com/medline/citation/20965438/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1474-4422(10)70209-X DB - PRIME DP - Unbound Medicine ER -