Survival after pulmonary edema due to enterovirus 71 encephalitis

Nolan, Melinda; Craig, Maria E.; Lahra, Monica M; Rawlinson, William D.; Prager, Peter; Williams, Gary; Bye, Ann; Andrews, Peter Ian

doi:10.1212/01.wnl.0000066810.62490.ff

Cited by 89 publications

(79 citation statements)

References 28 publications

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“…They usually appeared early in the illness and resolved after a few days, so that their presence may depend on the time of presentation. Like previous reports for HEV71 (3,6,8,10,15,18,27) and other HEVs (20,24), our study reports a low isolation rate of CSF (3 of 102 HFMD patients with aseptic meningitis). The yield would likely have been higher if PCR had been used (23), but this investigation is not available in most developing countries.…”

Section: Vol 45 2007 Diagnosis Of Hand-foot-and-mouth Disease 1863supporting

confidence: 89%

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Evaluation of Different Clinical Sample Types in Diagnosis of Human Enterovirus 71-Associated Hand-Foot-and-Mouth Disease

et al. 2007

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Human enterovirus 71 and coxsackievirus A16 are important causes of hand-foot-and-mouth disease (HFMD). Like other enteroviruses, they can be isolated from a range of sterile and nonsterile sites, but which clinical sample, or combination of samples, is the most useful for laboratory diagnosis of HFMD is not clear. We attempted virus culture for 2,916 samples from 628 of 725 children with HFMD studied over a 3 1/2-year period, which included two large outbreaks. Overall, throat swabs were the single most useful specimen, being positive for any enterovirus for 288 (49%) of 592 patients with a full set of samples. Vesicle swabs were positive for 169 (48%) of 333 patients with vesicles, the yield being greater if two or more vesicles were swabbed. The combination of throat plus vesicle swabs enabled the identification of virus for 224 (67%) of the 333 patients with vesicles; for this patient group, just 27 (8%) extra patients were diagnosed when rectal and ulcer swabs were added. Of 259 patients without vesicles, use of the combination of throat plus rectal swab identified virus for 138 (53%). For 60 patients, virus was isolated from both vesicle and rectal swabs, but for 12 (20%) of these, the isolates differed. Such discordance occurred for just 11 (10%) of 112 patients with virus isolated from vesicle and throat swabs. During large HFMD outbreaks, we suggest collecting swabs from the throat plus one other site: vesicles, if these are present (at least two should be swabbed), or the rectum if there are no vesicles. Vesicle swabs give a high diagnostic yield, with the added advantage of being from a sterile site.

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Section: Vol 45 2007 Diagnosis Of Hand-foot-and-mouth Disease 1863supporting

confidence: 89%

“…But for most outbreaks, vesicle fluid was not investigated (8,11,18,21,27). Because we wanted to examine the optimal number of lesions to sample, in our study we took separate swabs from each vesicle.…”

Section: Vol 45 2007 Diagnosis Of Hand-foot-and-mouth Disease 1863mentioning

confidence: 99%

Evaluation of Different Clinical Sample Types in Diagnosis of Human Enterovirus 71-Associated Hand-Foot-and-Mouth Disease

et al. 2007

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“…In some patients, DWI is able to demonstrate hyperintense changes in the posterior medulla without other brain abnormalities on T1WI or T2WI on the first day of neurological deterioration, underlining the superiority of DWI in early detection of infectious CNS disease compared with results of T2WI or contrast enhanced T1WI. 46 Japanese encephalitis (JE) affects approximately 50,000 people per year, of whom approximately 10,000 will die. As with other infectious CNS diseases, cranial MRI appears more sensitive than CT in detection of JE-related brain abnormalities.…”

Section: Viral Meningoencephalitismentioning

confidence: 99%

Neuroimaging of infections

2005

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Summary:Neuroimaging plays a crucial role in the diagnosis and therapeutic decision making in infectious diseases of the nervous system. The review summarizes imaging findings and recent advances in the diagnosis of pyogenic brain abscess, ventriculitis, viral disease including exotic and emergent viruses, and opportunistic disease. For each condition, the ensuing therapeutic steps are presented. In cases of uncomplicated meningitis, cranial computed tomography (CT) appears to be sufficient for clinical management to exclude acute brain edema, hydrocephalus, and pathology of the base of skull. Magnetic resonance imaging (MRI) is superior in depicting complications like sub-/epidural empyema and vasculitic complications notably on FLAIR (fluid-attenuated inversion recovery)-weighted images. The newer technique of diffusionweighted imaging (DWI) shows early parenchymal complications of meningitis earlier and with more clarity and is of help in differentiation of pyogenic abscess (PA) from ring enhancing lesions of other etiology. Proton magnetic resonance spectroscopy (PMRS) seems to produce specific peak patterns in cases of abscess. The presence of lactate cytosolic amino acids and absence of choline seems to indicate PA. Also in cases of suspected opportunistic infection due to toxoplasma DWI may be of help in the differentiation from lymphoma, showing no restriction of water diffusion. In patients with herpes simplex and more exotic viruses like West Nile and Murray Valley virus DWI allows earlier lesion detection and therapeutic intervention with virustatic drugs.

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“…In the past decade, HEV71-induced hand, foot, and, mouth disease outbreaks have mainly affected children within the Asia-Pacific region, including Hong Kong, China, Singapore, and Australia (8). The global control of poliovirus has also resulted in HEV71 becoming one of the most clinically significant etiological agents of acute neurological diseases such as polio-like acute flaccid paralysis, cerebellar ataxia, and brainstem encephalitis (9). No antiviral treatment has yet been developed to treat HEV71 infections; similarly, effective vaccines are currently unavailable, although several vaccine trials are being undertaken to develop effective therapeutic strategies to combat severe HEV71 infections.…”

mentioning

confidence: 99%

The Essential Role of Clathrin-mediated Endocytosis in the Infectious Entry of Human Enterovirus 71

Hussain

Leong

et al. 2011

Journal of Biological Chemistry

126

118

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Little is currently known about the infectious entry process of human enterovirus 71 (HEV71) into host cells, which may represent potential anti-viral targeting sites. In this study a targeted small-interfering RNA (siRNA) screening platform assay was established and validated to identify and profile key cellular genes involved in processes of endocytosis, cytoskeletal dynamics, and endosomal trafficking essential for HEV71 infection. Screen evaluation was conducted via the expression of well characterized dominant-negative mutants, bioimaging studies (double-labeled immunofluorescence assays, transmission electron microscopy analysis), secondary siRNA-based dosage dependence studies, and drug inhibition assays. The infectious entry of HEV71 into rhabdomyosarcoma cells was shown to be significantly inhibited by siRNAs targeting genes associated with clathrin-mediated endocytosis (CME) that include AP2A1, ARRB1, CLTC, CLTCL1, SYNJ1, ARPC5, PAK1, ROCK1, and WASF1. The functional role of CME was verified by the observation of strong co-localization between HEV71 particles and clathrin as well as dose-dependent inhibition of HEV71 infection upon siRNA knockdown of CME-associated genes. HEV71 entry by CME was further confirmed via inhibition by dominant-negative EPS15 mutants and treatment of CME drug inhibitors, with more than 80% inhibition observed at 20 M chlorpromazine. Furthermore, HEV71 infection was shown to be sensitive to the disruption of human genes in regulating early to late endosomal trafficking as well as endosomal acidic pH. The identification of clathrin-mediated endocytosis as the entry pathway for HEV71 infection of susceptible host cells contributes to a better understanding of HEV71 pathogenesis and enables future development of anti-viral strategies against HEV71 infection.

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Survival after pulmonary edema due to enterovirus 71 encephalitis

Abstract: Acute pulmonary edema and encephalomyelitis occurs with EV71 infection in infants. Long-term neurologic outcome varied from minor, focal weakness to profound, global motor dysfunction with respiratory failure.

Cited by 89 publications

References 28 publications

Evaluation of Different Clinical Sample Types in Diagnosis of Human Enterovirus 71-Associated Hand-Foot-and-Mouth Disease

Evaluation of Different Clinical Sample Types in Diagnosis of Human Enterovirus 71-Associated Hand-Foot-and-Mouth Disease

Neuroimaging of infections

The Essential Role of Clathrin-mediated Endocytosis in the Infectious Entry of Human Enterovirus 71

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