title: Fulminant enterovirus 71 infection: case report.
abstract: A previously healthy 3-year-old boy presented with high-grade fever, dyspnoea, alteration of consciousness, tachycardia and shock. A few erythematous macules and papules were seen on his palms and soles. Echocardiogram showed poor left ventricular contraction. Cardiac enzymes and pro-B-type natriuretic peptide were elevated. Milrinone, low-dose dopamine and intravenous immunoglobulin were administered. The patient recovered after 5 days without cardiac or neurological sequelae. The serological results showed a four-fold rise of enterovirus 71. In children with severe EV71 infection, early recognition of cardiopulmonary involvement and aggressive treatment are crucial to successful management.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: K
authors.initials: K
authors.lastname: Makonkawkeyoon
authors.forename: T
authors.initials: T
authors.lastname: Sudjaritruk
authors.forename: V
authors.initials: V
authors.lastname: Sirisanthana
authors.forename: S
authors.initials: S
authors.lastname: Silvilairat
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002675:Child, Preschool; D004298:Dopamine / Q000627:therapeutic use; D004452:Echocardiography; D029821:Enterovirus A, Human / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000175:diagnosis* / Q000473:pathology* / Q000503:physiopathology / Q000821:virology; D006321:Heart / Q000503:physiopathology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D020105:Milrinone / Q000627:therapeutic use; D009206:Myocardium / Q000473:pathology; D012123:Pulmonary Ventilation; D012769:Shock
chemical_list: D000914:Antibodies, Viral; D002316:Cardiotonic Agents; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D020105:Milrinone; D004298:Dopamine