Neurologic Involvement in an Outbreak of Enterovirus 71 Infection: A Hospital-Based Study

於腸病毒71型感染爆發期間之神經侵犯：一醫院之研究

廖宏才(Hung-Tsai Liao) ； 洪焜隆(Kun-Long Hung)

《Acta Paediatrica Taiwanica》 42卷1期 (2001/02) Pp. 27-32

https://doi.org/10.7097/APT.200102.0027

摘要

非小兒麻痺型腸病毒對兒童常造成中樞神經系統的侵犯，爲研究非小兒麻痺型腸病毒侵犯中樞神經系的臨床表現，我們從1998年2月至1999年元月，共收集了153例經病史、臨床表現或病毒培養證實爲非小兒麻痺型腸病毒感染而住院的病例。其中14例(9.2%)有中樞神經系統症狀表現，13例爲男性，1例爲女性，年齡層從1個月至10.3歲，中樞神經系統症狀包括無菌性腦膜炎4例(28.6%)，腦炎5例(35.7%)，腦脊髓炎3例(21.4%)，及類小兒麻痺症狀群2例(14.3%)。這些病人中，有8例(57.1%)經直腸或喉頭培養出腸病毒71型，死亡的兩例爲腦炎或腦脊髓炎併發肺水腫。一般而言，腸病毒被認爲是一較良性的傳染病。然而，小兒科醫師應謹記腸病毒71型曾造成數起地區性的流行而且可能引起嚴重的中樞神經疾患，因此地中樞神經系統之腸病毒感染給予早期評估及適當的治療可降低神經後遺症。

關鍵字

腸病毒71型 ； 類小兒麻痺症候群 ； 神經後遺症

並列摘要

Enterovirus (EV) can cause varied clinical manifestations. Involvement of the central nervous system (CNS) with the nonpolio EVs are common and important causes of morbidity in children. To investigate the manifestations of nonpolio enteroviral infections with CNS involvement during the LV outbreak, from February 1998 to January 1999, we collected 153 hospitalized patients in our pediatric ward caused by nonpolio EV infections which were diagnosed by history, clinical features, or detected from viral cultures. Fourteen patients (9.2%) had CNS presentations, 13 males and one female. The ages ranged from one month to 10.3 years. The spectrum of CNS presentations included aseptic meningitis (4 cases, 28.6%), encephalitis (5 case, 35.7%), encephalomyelitis (3 cases, 21.4%), and poliomyelitis-like syndrome (2 cases, 14.3%). Among these patients, 8 cases (57.1%) were isolated with EV7J from at least one site of rectal or throat swab sampling. Two fatal cases were presented as encephalitis and complicated with pulmonary edema. Generally, enteroviral infections are considered as a benign infectious disease in children. However, pediatricians should keep in mind that EV7J has caused several endemic outbreaks and continues to be an occasional cause of severe CNS disease. Early evaluation and appropriate treatment of CNS enteroviral infections may minimize the neurologic sequelae.

並列關鍵字

enterovirus 71 ； poliomyelitis-like syndrome ； neurologic sequelae