Mortality in Children with Severe Hand, Foot and Mouth Disease in Guangxi, China

Abstract

Objective: To analyze the clinical features of children with hand foot and mouth disease (HFMD) who died. Methods: 331 deaths due to HFMD between 2010 and 2014 were included in this retrospective study; 15 autopsies were performed. Results: Most deaths were seen in children aged below 3 y, and with enterovirus 71 infection (91%). The mean (SD) duration of HFMD from onset to death was 3.7(2.9) d. The mean (SD) age of fast progressors (from onset to death less than 4 days) was 17.4 (9.2) mo. Most of them were diagnosed as stage 3 and stage 4 of HFMD. Various pathological changes were observed in brain after autopsy, especially in brain stem and medulla. Conclusions: The brain stem encephalitis with the neurotropism of enteroviruses seems to be the main contributor to the death in HFMD.