title: A neonate with hand, foot, and mouth disease complicated with brainstem encephalitis and pulmonary edema:A complete recovery.
abstract: Hand, foot, and mouth disease (HFMD) with serious complications and fatal cases have been reported over the last decade worldwide. The authors report a rare case of HFMD in a neonate complicated with brainstem encephalitis and pulmonary edema. She had fever, lethargy, dyspnea. Physical examination revealed shock signs, fine rales on both lungs, absent Moro reflex. The patient had a rapidly progressive course with seizures, coma, no spontaneous breathing, chemosis. There were some vesicles on left sole and red maculopapular rashes on perianal skin. She had a history of exposure to HFMD. Fecal sample was positive for EV71 RNA by real-time PCR. Chest X-rays showed bilateral pulmonary infiltrates. MRI of the brain showed significant hypointensity in the brainstem on T1WI and hyperintensity on T2WI. She recovered well. This case highlights severe HFMD in neonates is rare. Medical history and physical examination are important in making diagnosis.
authors.affiliation: Shi-Jie Guo, Department of Neonatology, The First Hospital of Jilin University, Changchun 130021, China.
authors.forename: Shi-Jie
authors.initials: SJ
authors.lastname: Guo
authors.affiliation: Dong-Xuan Wang, Department of Ultrasonic Diagnosis, The First Hospital of Jilin University, Changchun 130021, China.
authors.forename: Dong-Xuan
authors.initials: DX
authors.lastname: Wang
authors.affiliation: Chun-Lai Dai, Department of Radiology, The First Hospital of Jilin University, Changchun 130021, China.
authors.forename: Chun-Lai
authors.initials: CL
authors.lastname: Dai
authors.affiliation: Hui Wu, Department of Neonatology, The First Hospital of Jilin University, Changchun 130021, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wu
keywords: Brainstem encephalitis; Enterovirus 71; Foot and mouth disease; Hand; Neonate; Pulmonary edema
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