Title:
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Enterovirus-A71 Rhombencephalitis Outbreak in Catalonia : Characteristics, Management and Outcome
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Author:
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Wörner, Núria; Rodrigo-García, Rocío; Antón, Andrés; Castellarnau, Ester; Delgado Martínez, Ignacio; Vazquez, Èlida; González, Sebastià; Mayol, Lluís; Méndez, Maria; Solé, Eduard; Rosal, Jaume; Andrés, Cristina; Casquero, Alejandro; Lera, Esther; Sancosmed, Mónica; Campins Martí, Magda; Pumarola Suñé, Tomàs; Rodrigo Gonzalo de Líria, Carlos
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Abstract:
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Observational, multicenter study analyzing characteristics, treatment and outcome of patients with EV-A71 rhombencephalitis diagnosed in 6 publicly funded hospitals within the Catalonian Health Institute. A review of clinical characteristics, diagnosis, treatment and outcome of these patients was conducted. Sixty-four patients met the clinical and virologic criteria for rhombencephalitis caused by EV-A71. All patients had symptoms suggesting viral disease, mainly fever, lethargy, ataxia and tremor, with 30% of hand-foot-mouth disease. Intravenous immunoglobulin therapy was given to 44/64 (69%) patients and methylprednisolone to 27/64 (42%). Six patients (9%) required pediatric intensive care unit admission. Three patients had acute flaccid paralysis of 1 limb, and another had autonomic nervous system (ANS) dysfunction with cardiorespiratory arrest. Outcome in all patients (except the patient with hypoxic-ischemic encephalopathy) was good, with complete resolution of the symptoms. During the 2016 outbreak, rhombencephalitis without ANS symptoms was the predominant form of presentation and most patients showed no hand-foot-mouth disease. These findings contrast with those of other patient series reporting associated ANS dysfunction (10%-15%) and hand-foot-mouth disease (60%-80%). Complete recovery occurred in almost all cases. In light of the favorable outcome in untreated mild cases, therapies for this condition should be reserved for patients with moderate-severe infection. The main relevance of this study is to provide useful information for setting priorities, management approaches and adequate use of resources in future EV-A71 associated rhombencephalitis outbreaks. |
Subject(s):
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-Enterovirus rhonbencephalitis |
Rights:
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open access
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https://creativecommons.org/licenses/by-nc-nd/4.0/ |
Document type:
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Article |
Published by:
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Uri:
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https://ddd.uab.cat/record/243799
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