Clinical analysis of herpangina caused by major pathogens during outbreak of hand-foot-mouth disease / 中国医师进修杂志

ABSTRACT

Objective To analyze the clinical characteristics of herpangina caused by major pathogens during outbreak of hand-foot-mouth disease (HFMD).Methods The clinical data of 94 patients with herpangina during outbreak of HFMD were collected.Enteroviruses 71 (EV71) and Coxsackie virus A16 (CA16) were detected by real-time polymerase chain reaction.And relevant indicators of two groups were compared.Results There were 34 cases EV71 positive (36.17％,34/94,EV71 positive group) and 31 cases CoxA 16 positive (32.98％,31/94,CoxA 16 positive group) from the results of pathogen detection.The level of white blood cell count,glucose,erythrocyte sedimentation rate,hypersensitive C-reactive protein were increased obviously than normal,while no significant difference was found between two groups (P ＞ 0.05).The level of myocardial enzymes,creatinine,blood urea nitrogen were in the normal range and no significant difference was found between two groups (P ＞ 0.05).There was no significant difference between two groups in the incidence of age ＜ 3 years old,persistent high fever (P ＞ 0.05).The abnormalities performance in the nervous,respiratory,circulatory system of the EV71 positive group were significantly higher than those in CoxA 16 positive group [26.47％ (9/34) vs.6.45％ (2/31),23.53％ (8/34) vs.3.23％(1/31),20.59％ (7/34) vs.3.23％ (1/31) separately],and there were significant differences between two groups(P ＜ 0.05).There were 11 severe cases (11.70％,11/94) in the 94 cases of children with herpangina,and 9 cases belonged to the EV71 positive group,2 cases belonged to the CoxA16 positive group.Two cases died of lung hemorrhage,1 case occurred of paralysis,all of them were detected EV71 positive.Conclusions The pathogen of herpangina might be same as the pathogen during the outbreak of HFMD.Children with herpangina during outbreak of HFMD should be incorporated into the management of HFMD.EV71 positive children are serious than CoxA16 positive cases,and detecting pathogens will be helpful to determine the prognosis.