A Case Report of a Teenager with Severe Hand, Foot, and Mouth Disease with Brainstem Encephalitis Caused by Enterovirus 71

Overview

Journal BMC Pediatr

Publisher Biomed Central

Specialty Pediatrics

Date 2019 Feb 15

PMID 30760232

Citations 8

Authors

Ying-Fu Chen

Lan Hu

Feng Xu

Cheng-Jun Liu

Jing Li

Affiliations

Soon will be listed here.

Abstract

Background: Hand, foot, and mouth disease (HFMD) is an acute viral infection occurring mostly in infants and children. Enterovirus 71 (EV71) infection mostly occurs in children < 5 years of age. Severe cases, however, are usually encountered in children under the age of 3 years, and exceedingly rare in teenagers > 14 years and adults.

Case Presentation: We report a rare case of HFMD in a 16-year-old male teenager residing in Chonqing, China. The clinical presentation was typical of HFMD and included vesicular lesions and oral mucosal ulcers, macular and vesicular lesions on palms and soles. He developed severe neurological complications that were suggestive of brainstem encephalitis. EV71 RNA was detected in the patient's faecal samples by reverse transcription-polymerase chain reaction. Specific IgM antibody to EV71 was detected in both serum and cerebrospinal fluid by ELISA. Gamma immunoglobulin therapy at 25 g/day was administered for 2 days, along with methylprednisolone, mannitol, ganglioside, and creatine phosphate sodium. The patient showed neurological improvement and recovered completely in 1 month.

Conclusions: This case indicates that EV71 infection may cause HFMD in teenagers with potentially severe neurological involvement. Clinicians should be aware of the possibility of HFMD occurring in adults and teenagers as prompt treatment could be life-saving in these patients.

Citing Articles

Insight into the Life Cycle of Enterovirus-A71.

Liu Q, Long J Viruses. 2025; 17(2).

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Hand, foot and mouth disease (HFMD): A case report.

Suryawanshi H, Sahu M, Singh P J Oral Maxillofac Pathol. 2024; 28(3):464-466.

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Changing Epidemiology of Hand, Foot, and Mouth Disease Causative Agents and Contributing Factors.

Kalam N, Balasubramaniam V Am J Trop Med Hyg. 2024; 111(4):740-755.

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Metformin inhibits EV71‑induced pyroptosis by upregulating DEP domain‑containing mTOR‑interacting protein.

Zhang X, Sun C, Hao J, Cao L, Zhang X, Du J Exp Ther Med. 2023; 26(2):388.

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Hand, Foot, and Mouth Disease: A Narrative Review.

Leung A, Lam J, Barankin B, Leong K, Hon K Recent Adv Inflamm Allergy Drug Discov. 2022; 16(2):77-95.

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