Hand-foot-mouth disease combined with neurogenic pulmonary edema in children: 11 cases report
Objective To analyze clinical presentations of children's neurogenic pulmonary edema due to severe hand-foot-mouth disease (HFMD), and inquire the effective treatment. Methods The clinical data of 11 children diagnosed as neurogenic pulmonary edema associated with severe HFMD in our hospital w...
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| Format: | Article |
| Language: | English |
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Tianjin Huanhu Hospital
2018-03-01
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| Series: | Chinese Journal of Contemporary Neurology and Neurosurgery |
| Subjects: | |
| Online Access: | http://www.cjcnn.org/index.php/cjcnn/article/view/1751 |
| _version_ | 1818298060469436416 |
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| author | Xing-nan JIN Ying-xue ZOU Mei YU Zhuo-lin LU |
| author_facet | Xing-nan JIN Ying-xue ZOU Mei YU Zhuo-lin LU |
| author_sort | Xing-nan JIN |
| collection | DOAJ |
| description | Objective To analyze clinical presentations of children's neurogenic pulmonary edema due to severe hand-foot-mouth disease (HFMD), and inquire the effective treatment. Methods The clinical data of 11 children diagnosed as neurogenic pulmonary edema associated with severe HFMD in our hospital were retrospectively analyzed. The clinical manifestation, laboratory examination, imaging and neuropsychological examination were analyzed. Results All patients were younger than 5 years, and all contacted with severe HFMD. They presented with fever, skin rash, irritability and pulmonary edema. Glasgow Coma Scale (GCS) score of 4 cases was ≤ 7 on admission; head MRI of 5 cases showed long T1 and T2 signals in pons and medulla, 2 cases showed long T2 signal in pons, and one case showed long T1 and T2 signals in medulla; echocardiography ejection fraction (EF) of 9 cases was ≥ 41.50%. Patients were treated by tracheal intubation assisted ventilation, decreasing intracranial pressure, rational vasoactive agents, corticosteroids, intravenous immunoglobulin (IVIg) assisted by nerve cells nutrition and myocardial support. Antibiotic therapy was used when combined with breathing machine related pneumonia. After treatment, 3 cases (3/11) died, 3 cases (3/11) were cured and 5 cases (5/11) had paralysis sequelae and referred to rehabilitation. Conclusions Neurogenic pulmonary edema combined with severe HFMD has acute onset, rapid proceeding and high mortality. Tracheal intubation assisted ventilation, decreasing intracranial pressure, rational vasoactive agents, corticosteroids and IVIg can improve the prognosis. The key points of treatment are early tracheal intubation assisted ventilation and proper treating of neurogenic circulation dysfunction.
DOI: 10.3969/j.issn.1672-6731.2018.03.009 |
| first_indexed | 2024-12-13T04:29:19Z |
| format | Article |
| id | doaj.art-f319e8a39bdf43b2bd7984276936a93a |
| institution | Directory Open Access Journal |
| issn | 1672-6731 |
| language | English |
| last_indexed | 2024-12-13T04:29:19Z |
| publishDate | 2018-03-01 |
| publisher | Tianjin Huanhu Hospital |
| record_format | Article |
| series | Chinese Journal of Contemporary Neurology and Neurosurgery |
| spelling | doaj.art-f319e8a39bdf43b2bd7984276936a93a2022-12-21T23:59:37ZengTianjin Huanhu HospitalChinese Journal of Contemporary Neurology and Neurosurgery1672-67312018-03-011831982031708Hand-foot-mouth disease combined with neurogenic pulmonary edema in children: 11 cases reportXing-nan JIN0Ying-xue ZOU1Mei YU2Zhuo-lin LU3Department of Infectious Diseases, Tianjin Children's Hospital, Tianjin 300134, ChinaDepartment of Infectious Diseases, Tianjin Children's Hospital, Tianjin 300134, ChinaDepartment of Infectious Diseases, Tianjin Children's Hospital, Tianjin 300134, ChinaDepartment of Infectious Diseases, Tianjin Children's Hospital, Tianjin 300134, ChinaObjective To analyze clinical presentations of children's neurogenic pulmonary edema due to severe hand-foot-mouth disease (HFMD), and inquire the effective treatment. Methods The clinical data of 11 children diagnosed as neurogenic pulmonary edema associated with severe HFMD in our hospital were retrospectively analyzed. The clinical manifestation, laboratory examination, imaging and neuropsychological examination were analyzed. Results All patients were younger than 5 years, and all contacted with severe HFMD. They presented with fever, skin rash, irritability and pulmonary edema. Glasgow Coma Scale (GCS) score of 4 cases was ≤ 7 on admission; head MRI of 5 cases showed long T1 and T2 signals in pons and medulla, 2 cases showed long T2 signal in pons, and one case showed long T1 and T2 signals in medulla; echocardiography ejection fraction (EF) of 9 cases was ≥ 41.50%. Patients were treated by tracheal intubation assisted ventilation, decreasing intracranial pressure, rational vasoactive agents, corticosteroids, intravenous immunoglobulin (IVIg) assisted by nerve cells nutrition and myocardial support. Antibiotic therapy was used when combined with breathing machine related pneumonia. After treatment, 3 cases (3/11) died, 3 cases (3/11) were cured and 5 cases (5/11) had paralysis sequelae and referred to rehabilitation. Conclusions Neurogenic pulmonary edema combined with severe HFMD has acute onset, rapid proceeding and high mortality. Tracheal intubation assisted ventilation, decreasing intracranial pressure, rational vasoactive agents, corticosteroids and IVIg can improve the prognosis. The key points of treatment are early tracheal intubation assisted ventilation and proper treating of neurogenic circulation dysfunction. DOI: 10.3969/j.issn.1672-6731.2018.03.009http://www.cjcnn.org/index.php/cjcnn/article/view/1751Hand, foot and mouth diseasePulmonary edemaEnterovirus infectionsEchocardiography |
| spellingShingle | Xing-nan JIN Ying-xue ZOU Mei YU Zhuo-lin LU Hand-foot-mouth disease combined with neurogenic pulmonary edema in children: 11 cases report Chinese Journal of Contemporary Neurology and Neurosurgery Hand, foot and mouth disease Pulmonary edema Enterovirus infections Echocardiography |
| title | Hand-foot-mouth disease combined with neurogenic pulmonary edema in children: 11 cases report |
| title_full | Hand-foot-mouth disease combined with neurogenic pulmonary edema in children: 11 cases report |
| title_fullStr | Hand-foot-mouth disease combined with neurogenic pulmonary edema in children: 11 cases report |
| title_full_unstemmed | Hand-foot-mouth disease combined with neurogenic pulmonary edema in children: 11 cases report |
| title_short | Hand-foot-mouth disease combined with neurogenic pulmonary edema in children: 11 cases report |
| title_sort | hand foot mouth disease combined with neurogenic pulmonary edema in children 11 cases report |
| topic | Hand, foot and mouth disease Pulmonary edema Enterovirus infections Echocardiography |
| url | http://www.cjcnn.org/index.php/cjcnn/article/view/1751 |
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