Enterovirus-A71 Rhombencephalitis Outbreak in Catalonia : Characteristics, Management and Outcome
Wörner, Núria (Hospital Universitari Vall d'Hebron)
Rodrigo-García, Rocío (Hospital Universitari Vall d'Hebron)
Antón, Andrés (Universitat Autònoma de Barcelona)
Castellarnau, Ester (Hospital Universitari Joan XXIII de Tarragona)
Delgado Martínez, Ignacio (Hospital Universitari Vall d'Hebron)
Vazquez, Èlida (Hospital Universitari Vall d'Hebron)
González, Sebastià (Hospital Universitari Vall d'Hebron)
Mayol, Lluís (Hospital Universitari de Girona Doctor Josep Trueta)
Méndez, Maria (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Solé, Eduard (Hospital Arnau de Vilanova (Lleida, Catalunya))
Rosal, Jaume (Hospital de Tortosa Verge de la Cinta)
Andrés, Cristina (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Casquero, Alejandro (Hospital Universitari Vall d'Hebron)
Lera, Esther (Hospital Universitari Vall d'Hebron)
Sancosmed, Mónica (Hospital Universitari Vall d'Hebron)
Campins Martí, Magda (Hospital Universitari Vall d'Hebron)
Pumarola Suñé, Tomàs (Universitat Autònoma de Barcelona)
Rodrigo Gonzalo de Líria, Carlos (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)

Data:	2021
Resum:	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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Enterovirus rhonbencephalitis
Publicat a:	The Pediatric infectious disease journal, Vol. 40 (june 2021) , p. 628-633, ISSN 1532-0987

DOI: 10.1097/INF.0000000000003114
PMID: 34097655

6 p, 552.4 KB

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