A First Case of Acute Flaccid Myelitis Related to Enterovirus D68 in Belgium: Case Report
Introduction: We describe the first case of acute flaccid myelitis (AFM) related to enterovirus D68 (EV-D68) infection in Belgium. The clinical and radiological presentation of AFM associated with EV-D68 although well described currently remains a challenging diagnosis. Through this interesting clin...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2024-01-01
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| Series: | Case Reports in Neurology |
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| Online Access: | https://beta.karger.com/Article/FullText/535316 |
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| author | Marine Rodesch Claudine Sculier Valentina Lolli Gauthier Remiche Iris Delpire Christophe Fricx Françoise Vermeulen Florence Christiaens |
| author_facet | Marine Rodesch Claudine Sculier Valentina Lolli Gauthier Remiche Iris Delpire Christophe Fricx Françoise Vermeulen Florence Christiaens |
| author_sort | Marine Rodesch |
| collection | DOAJ |
| description | Introduction: We describe the first case of acute flaccid myelitis (AFM) related to enterovirus D68 (EV-D68) infection in Belgium. The clinical and radiological presentation of AFM associated with EV-D68 although well described currently remains a challenging diagnosis. Through this interesting clinical case, we aimed to review the differential diagnosis of acute flaccid palsy in a child and discuss the specific point of interest related to AFM. Case Presentation: We present the case of a 4-year-old girl with a torticollis associated with an acute palsy of the right upper limb. The magnetic resonance imaging revealed an increased T2 signal intensity of the entire central gray matter of the cervical cord with involvement of the posterior brainstem. A polymerase chain reaction (PCR) conducted on a nasopharyngeal swab was found positive for EV-D68. The definition of AFM proposed by the Center for Disease Control and Prevention (CDC) is an acute-onset flaccid weakness of one or more limbs in the absence of a clear alternative diagnosis and the radiological evidence of gray matter involvement on an MRI picture, and our case fits these two criteria. A prompt and detailed workup is required to distinguish this emergent disease from other forms of acute flaccid palsy. The functional prognosis of AFM is poor, and there are no evidence-based treatment guidelines so far. Conclusion: AFM is an emerging pathology that requires the attention of pediatricians to quickly rule out differential diagnoses and adequately manage the patient. Further research is needed to optimize treatments, improve outcomes, and provide scientifically based guidelines. |
| first_indexed | 2024-03-07T19:39:32Z |
| format | Article |
| id | doaj.art-a216719f95b144beb3fa57cc3d063baa |
| institution | Directory Open Access Journal |
| issn | 1662-680X |
| language | English |
| last_indexed | 2024-03-07T19:39:32Z |
| publishDate | 2024-01-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Neurology |
| spelling | doaj.art-a216719f95b144beb3fa57cc3d063baa2024-02-29T07:06:18ZengKarger PublishersCase Reports in Neurology1662-680X2024-01-01161414710.1159/000535316535316A First Case of Acute Flaccid Myelitis Related to Enterovirus D68 in Belgium: Case ReportMarine Rodesch0Claudine Sculier1Valentina Lolli2Gauthier Remiche3Iris Delpire4Christophe Fricx5Françoise Vermeulen6Florence Christiaens7Department of Pediatrics, Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, BelgiumDepartment of Neuropediatrics, Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, BelgiumDepartment of Radiology, Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, BelgiumCentre de Référence Neuromusculaire, Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, BelgiumDepartment of Pediatrics, Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, BelgiumDepartment of Pediatrics, Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, BelgiumDepartment of Pediatrics, Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, BelgiumDepartment of Neuropediatrics, Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, BelgiumIntroduction: We describe the first case of acute flaccid myelitis (AFM) related to enterovirus D68 (EV-D68) infection in Belgium. The clinical and radiological presentation of AFM associated with EV-D68 although well described currently remains a challenging diagnosis. Through this interesting clinical case, we aimed to review the differential diagnosis of acute flaccid palsy in a child and discuss the specific point of interest related to AFM. Case Presentation: We present the case of a 4-year-old girl with a torticollis associated with an acute palsy of the right upper limb. The magnetic resonance imaging revealed an increased T2 signal intensity of the entire central gray matter of the cervical cord with involvement of the posterior brainstem. A polymerase chain reaction (PCR) conducted on a nasopharyngeal swab was found positive for EV-D68. The definition of AFM proposed by the Center for Disease Control and Prevention (CDC) is an acute-onset flaccid weakness of one or more limbs in the absence of a clear alternative diagnosis and the radiological evidence of gray matter involvement on an MRI picture, and our case fits these two criteria. A prompt and detailed workup is required to distinguish this emergent disease from other forms of acute flaccid palsy. The functional prognosis of AFM is poor, and there are no evidence-based treatment guidelines so far. Conclusion: AFM is an emerging pathology that requires the attention of pediatricians to quickly rule out differential diagnoses and adequately manage the patient. Further research is needed to optimize treatments, improve outcomes, and provide scientifically based guidelines.https://beta.karger.com/Article/FullText/535316enterovirusacute flaccid palsymotor deficitspinal cordcase report |
| spellingShingle | Marine Rodesch Claudine Sculier Valentina Lolli Gauthier Remiche Iris Delpire Christophe Fricx Françoise Vermeulen Florence Christiaens A First Case of Acute Flaccid Myelitis Related to Enterovirus D68 in Belgium: Case Report Case Reports in Neurology enterovirus acute flaccid palsy motor deficit spinal cord case report |
| title | A First Case of Acute Flaccid Myelitis Related to Enterovirus D68 in Belgium: Case Report |
| title_full | A First Case of Acute Flaccid Myelitis Related to Enterovirus D68 in Belgium: Case Report |
| title_fullStr | A First Case of Acute Flaccid Myelitis Related to Enterovirus D68 in Belgium: Case Report |
| title_full_unstemmed | A First Case of Acute Flaccid Myelitis Related to Enterovirus D68 in Belgium: Case Report |
| title_short | A First Case of Acute Flaccid Myelitis Related to Enterovirus D68 in Belgium: Case Report |
| title_sort | first case of acute flaccid myelitis related to enterovirus d68 in belgium case report |
| topic | enterovirus acute flaccid palsy motor deficit spinal cord case report |
| url | https://beta.karger.com/Article/FullText/535316 |
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