Adult case of acute flaccid paralysis with enterovirus D68 detected in the CSF

Clinical Features of Acute Flaccid Myelitis Temporally Associated With an Enterovirus D68 Outbreak: Results of a Nationwide Survey of Acute Flaccid Paralysis in Japan, August–December 2015

“…Among 20 cases tested, 7 (35%) were EV-D68 positive: 3 from respiratory, 2 from stool, 1 from CSF, and 1 from nasopharyngeal, serum, and tracheal aspiration samples (a pediatric case with preceding steroid usage) [ 21 ]. Remarkably, EV-D68 was detected in a CSF sample collected 1 day after the AFM onset from an adult AFM case ( Table 1 , case 54) by EV-D68–specific real-time RT-PCR [ 22 ]. Two additional AFM cases with EV-D68–positive nasopharyngeal samples were identified at PMPHIs, for a total of 9 EV-D68–positive cases (15%) ( Table 2 ).…”

“…Only 3 cases, 1 adult with AFM [ 22 ], 1 adult with ACB, and a pediatric AFM patient with early steroid usage [ 21 ], had EV-D68 in blood or CSF specimens, suggesting that host susceptibility factors increase the risk of neurological manifestations. Administration of steroids for asthma in the pediatric patient 5 days before neurological onset may have induced transient immunosuppression and persistent viremia.…”

Molecular typing and characterization of a novel genotype of EV-B93 isolated from Tibet, China

“…Enteroviruses have complex pathogenesis and can cause a wide spectrum of diseases, but most people get a silent infection. Clinical symptoms of various severities may occur in cases of depressed immunity and recurrent exposure to viruses, such as acute flaccid paralysis (AFP); hand, foot, and mouth disease; aseptic meningitis; acute pulmonary oedema; myocarditis [12][13][14][15][16][17]. Some critically ill patients may die quickly.…”