The clinical character of hand-foot-and-mouth-disease (HFMD) with neurological manifestation: A report of 22 death and 36 recovered cases

Abstract

Background: Outbreaks of hand-foot-and-mouth disease (HFMD) have occurred in many parts of the world, particularly in China. The disease usually has ease of communicability and a higher risk of developing severe complications leading towards death. In this study, we aim to evaluate the clinical features, laboratory examination, and treatment for serious cases of HFMD, using a retrospective analysis based on clinical data. Methods: We report the clinical features of 22 deceased patients with confirmed diagnoses of HFMD, who presented to hospitals in the Shanxi Province of China between June 2010, and August 2012. Demographic, clinical and laboratory data from inpatients were collected. Results: The findings of this report showed that Enterovirus 71 (EV71) is the causative agent of HFMD, particularly in male children under the age of 3. Some common symptoms including fever, rash, and malfunctioning of respiratory, circulatory, and neurologic systems were observed in all studied patients. However, circulatory failure was the most important cause of death for these patients. Furthermore, increases in the peripheral white blood cell count (>15 × 109/L) and the blood sugar level (>8.3 mmol/L) are among the important reference indices for serious cases. Hence, on time provision of respiratory and circulatory supports enhance the efficiency of a comprehensive treatment strategy. Conclusion: HFMD, characterized by high fever, convulsions, mental fatigue, vomiting and cold limbs, carries a high risk of death. Earlier identification of higher-risk infants might allow for more rapid intervention. Our findings suggest that the peripheral white blood cell count (>15 × 109/L) and the blood sugar level (>8.3 mmol/L) should be considered as warning signs while, clinicians manage surges of children diagnosed with HFMD to avoid death.