https://scholars.lib.ntu.edu.tw/handle/123456789/525659
標題: | Clinical features and factors of unfavorable outcomes for non-polio enterovirus infection of the central nervous system in northern Taiwan, 1994-2003 | 作者: | Yang T.-T. LI-MIN HUANG CHUN-YI LU CHUAN-LIANG KAO WANG-TSO LEE PING-ING LEE Chen C.-M. Huang F.-Y. CHIN-YUN LEE LUAN-YIN CHANG |
公開日期: | 2005 | 卷: | 38 | 期: | 6 | 起(迄)頁: | 417-424 | 來源出版物: | Journal of Microbiology, Immunology and Infection | 摘要: | This study investigated the clinical manifestations and outcomes of central nervous system (CNS) infection by enteroviruses. Cases with CNS involvement among all enterovirus-culture-positive cases from January 1995 to June 2003 were retrospectively reviewed. Among 1028 enterovirus-culture-positive cases, there were 333 cases involving the CNS. Of these, the ratio of male to female subjects was 1.78, and the mean (± standard deviation) age was 6.83 ± 5.9 years; 21 were premature neonates, and 10 failed to thrive. Disease entities included 282 cases of aseptic meningitis (84.7%), 44 cases of encephalitis (13.2%), and 7 cases of encephalomyelitis/polio-like syndrome (2.1%). Of these cases, 97.9% (326/333) had fever with peak body temperature at 38.9°C, 85% had headache and vomiting, 70% had meningeal signs, 64% had neck stiffness, 16.6% (55/333) had change of consciousness, 5.4% (18/333) had seizures and 5.2% (17/333) had myoclonic jerks. Mannitol was administered in 77.2% of patients (257/333), along with intravenous immunoglobulin in 6.6% (22/333). Twelve cases received ventilator support. One patient died of hand-foot-and-mouth disease, encephalitis plus cardiopulmonary failure, and 2 premature neonates died of hepatic failure, disseminated intravascular coagulation, sepsis-like syndrome and myocarditis. Eighteen had neurologic sequelae, including 7 with limb weakness, 5 with epilepsy, 2 with sixth cranial nerve palsy, 3 with cerebral palsy, 4 with psychomotor retardation, 2 with spasticity, and 1 with hearing loss. Factors associated with unfavorable outcomes (death or sequelae) included younger age (p=0.0003), higher peak white blood cell count (WBC) [p=0.0009] and skin rash (p=0.005). Younger age and higher peak WBC were poor prognostic factors of severe enterovirus CNS infection. Death was related to neonatal enterovirus infection and enterovirus 71 infection in young children. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-33344477760&partnerID=40&md5=364f79a2385a266be7058fac16ea0fab https://scholars.lib.ntu.edu.tw/handle/123456789/525659 |
ISSN: | 1684-1182 | SDG/關鍵字: | antibiotic agent; immunoglobulin; mannitol; adolescent; adult; article; aseptic meningitis; assisted ventilation; blood cell count; body temperature; central nervous system; central nervous system infection; child; clinical feature; controlled study; demography; disease severity; encephalitis; encephalomyelitis; Enterovirus infection; female; human; human cell; infant; laboratory test; major clinical study; male; neurologic disease; newborn; Poliomyelitis virus; prognosis; rash; Taiwan; Adolescent; Adult; Age Factors; Central Nervous System Viral Diseases; Child; Child, Preschool; Enterovirus Infections; Female; Humans; Infant; Infant, Newborn; Male; Prognosis; Retrospective Studies; Taiwan |
顯示於: | 醫學系 |
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