Fatal caseofechovirus type9encephalitis

Enteroviruses are rare causes ofacute focalencephalitis. A fatalcase of echovirus type9infection isreported ina 9 montholdboywho presented witha feveranda macularrashfoliowed bytwo focalseizures. Echovirus type9was isolated fromlungtissue after seven days. TClin Pathol1993;46:865-866) The non-polio enteroviruses, inparticular about80% of thecoxsackie virusand echovirus serotypes, arethebestknownviral associations ofaseptic meningitis. Theyare also rarecausesofacutefocal encephalitis in children andadolescents.' Echoviruses were notedtobea frequent cause offebrile illness andaseptic meningitis soon after theywere first isolated fromthefaeces ofasymptomatic children inthe1950s. Theclinical features ofechoviral infections include apinkmacular ormaculopapular rash over most ofthebodywhichiscommonly seeninyoung children andmay last forthree to fivedays.Lessoftentherashmay be petechial or purpuric. In severe infections hepatoadrenal failure hasbeenreported, and ininfants withechoviral meningoencephalitis theheartandlungshavealsobeenreported tobeaffected. Usually thenormal course is one ofrapidspontaneousclinical improvement. The clinical signsand pathology observed inenteroviral meningoencephalitis varyinseverity depending on theextentto whichthecentral nervous systemisaffected.