Three pediatric cases of group A coxsackievirus-associated encephalitis/encephalopathy

• Published in: No to hattatsu Vol. 44; no. 5; p. 397
• Main Authors: Aizaki, Koichi, Tsuru, Tomohiko, Okumura, Keiko, Kondo, Noriko
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.09.2012
• Subjects: Brain Diseases - etiology; Child, Preschool; Coxsackievirus Infections - complications; Encephalitis, Viral - etiology; Female; Humans; Male
• ISSN: 0029-0831
• DOI: 10.11251/ojjscn.44.397

We report three pediatric cases of group A coxsackievirus-associated encephalitis/encephalopathy. A 4-year-old girl with coxsackievirus A6 infection presented with an exanthem on her upper body on the fourth day of fever. The following day, she developed an episode of convulsions, and subsequently experienced sudden cardiopulmonary arrest. A head computed tomography scan revealed severe brain edema. Two patients with neurological sequelae had initially presented with status epilepticus that required intravenous barbiturate treatment. Both cases had high-signal-intensity lesions on their diffusion-weighted brain magnetic resonance images. A 5-year-old girl with subcortical white matter lesions was diagnosed with acute encephalopathy with febrile convulsive status epilepticus, and a 2-year-old boy with bilateral hippocampal lesions was diagnosed with parainfectious limbic encephalitis. These findings indicate that group A coxsackievirus is a causative agent of pediatric encephalitis/encephalopathy; moreover, the prognosis may be poor in some cases.