Clinical character and etiology analysis of 214 severe hand, foot and mouth disease children with complicating encephalitis

Objective To summarize clinical feature of severe hand,foot and mouth disease (HFMD) complicating encephalitis and analyze its pathogens.Methods A total of 214 severe HFMD cases complicating encephalitis hospitalized children in June 2011 in our hospital were entrolled in 279 HFMD cases.214 cases were given milrinone to decrease intracranial pressure.Hormone and antivirus drug were applied in a short-term to resistance the infection,and other adjuvant therapy.31 critical cases were given the oxygen,milrinone and phentolamine during the treatment.49 cases who were critical cases or more severe cases were give intravenous immunoglobulin,6 cases combined with respiratory and circulatory failure and applied the mechanical ventilation.Excrement etiology of 213 cases were detected by RT-PCR.Results In 279 patients,of 214 cases were severe HFMD,account for 76.70％.The proportion of male and female was 1.55∶1.The ratio of urban and rural area was 1 ∶ 1.24.There were 212 cases had fever and the mean course of fever before going to hospital was 2.91 days.The temperature of 169 cases were 39-40 ℃ (79.72％).All the patients had HFMD typical rashes.The main menifestations were knee jerk reflex hyperfunction( 199 cases,92.99％),neck resistance ( 191 cases,89.25％ ),and easy to panic(166 cases,77.57％ ),cerebrospinal fluid of all patients were abnormal.212 patients were cured,2 cases with acute flaccid paralysis of lower extremity had significantly better on discharge and continued to use prednisone and a variety of vitamins,and were cured when following up for 2 weeks.The average hospitalization time was 7.43 days(5-18 days).200 cases were detected enteric virus in213 cases (93.90％),in which EV71 were 191 cases (95.50％).Conclusions A higher proportion of severe HFMD patients are admitted in our hospital.To the critical cases,phenollamin and milrinone should be given as soon as possible.Actively reducing the intracranial pressure and anti-infection treatment could decrease the mortality and morbidity in maximum.EV71 was still the main pathogen Key words: Hand, foot and mouth disease; Severe case; Etiology