| Popis: |
Enteroviruses are a type of RNA-strained virus with more than 100 different genotypes. Infection can be asymptomatic, or symptoms can range from mild to severe. Some patients can develop neurological involvement, such as aseptic meningitis, encephalitis, or even cardiorespiratory failure. However, in children, the risk factors for developing severe neurological involvement are not well understood. The aim of this retrospective study was to determine the risk factors associated with severe neurological involvement in children hospitalized for neurological disease after enterovirus infection. One-hundred and seven children hospitalized from 2009 to 2019 were included. Patients were classified according to the World Health Organization case definition for neurological complications in hand, foot and mouth disease. Our findings showed that, in children between age 2 and 5, the appearance of neurological symptoms within the first 12 hours from infection onset—especially if associated with skin rash—was a significant risk factor for severe neurological involvement. Detection of enterovirus in cerebrospinal fluid was more likely in patients with aseptic meningitis. By contrast, other biological samples (e.g., feces or nasopharyngeal fluids) were necessary to detect enterovirus in patients with encephalitis. The genotype most commonly associated with the most severe neurological conditions was EV-A71. E-30 was mostly associated with aseptic meningitis. Awareness of the risk factors associated with worse neurological outcomes could help clinicians to better manage these patients to avoid unnecessary admissions and/or ancillary tests. |
