A fatal case of acute encephalopathy in a child due to coxsackievirus A2 infection: a case report

BMC Infectious Diseases

Masami Konagaya¹  Nozomu Hanaoka¹  Tsuguto Fujimoto¹  Keiko Tanaka-Taya²  Toshiji Mukai³  Tomonori Nagai³  Harutaka Katano⁴  Hiroyuki Shimizu⁵ 

[1] Center for Emergency Preparedness and Response, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, 162-8640, Tokyo, Japan;Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, 1-23-1 Shinjuku-ku, 162-8640, Tokyo, Japan;Department of Legal Medicine, ST. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, 216-8511, Kawasaki-shi, Kanagawa, Japan;Department of Pathology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, 162-8640, Tokyo, Japan;Department of Virology II, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama-shi, 208-0011, Tokyo, Japan;

关键词: Encephalopathy;    Coxsackievirus A2;    Sudden death;    Autopsy;    Case report;   

DOI  :  10.1186/s12879-021-06858-2

来源: Springer

【 摘 要 】

BackgroundCertain types of enteroviruses, including coxsackieviruses, cause encephalitis, and other neurological complications. However, these pathogens rarely cause fatal infections, especially in immunocompetent infants. In this study, we present a rare case of acute encephalopathy caused by coxsackievirus A2 (CV-A2), which progressed rapidly in a previously healthy female child.Case presentationIn June 2013, a 26-month-old female child from Kanagawa, Japan, was found unresponsive during sleep. She was healthy until that morning. Her temperature was 37 °C at 08:00. She was feeling fine and went to the nursery that same morning. However, her condition worsened around noon. Therefore, she went home and slept at around 13:00. Surprisingly, after 2 h, her parents checked on her and found that she was lying on her back and was not breathing. Hence, she was immediately taken to a hospital by ambulance, but she was declared dead on arrival at the hospital. Subsequently, pathological autopsy and pathogenetic analysis, including multiple pathogen detection real-time PCR, were conducted to investigate the cause of death. The examination results revealed that she had an infectious respiratory disease and acute encephalopathy due to a CV-A2 infection.ConclusionsBased on our findings, we concluded that a previously healthy girl who had no immediate history of underlying medical condition were susceptible to death by acute encephalopathy due to CV-A2 infections. We proposed this conclusion because the patient’s condition progressed rapidly in less than 2 h and eventually led to her death. This is the first report on an acute encephalitis-dependent death in a child due to CV-A2 infection.

【 授权许可】

CC BY