Analysis Of Clinical Features Among Different Pathogens In Severe Hand, Foot And Mouth Disease

Objective : Analyze the pathogenic composition of severe HFMD,compare the clinical features of different pathogens and the differences in auxiliary examinations,and provide evidence for the effective prevention and treatment of HFMD.Methods:The clinical data of 381 children with severe HFMD from April 2016 to March 2017 in Children's Hospital of Chongqing Medical University were collected by questionnaires and interviews.Quantitative fluorescence PCR was used to classify etiology based on stool samples or throat swabs from.them.Results:1)There are three major types of HFMD pathogens: EV71,EUV,and CoxA16,of which EV71 and EUV are the major pathogens of children with severe HFMD,and EV71 is the major pathogen of severe hand-foot-mouth disease;2)According to the different pathogens,the children were divided into 3 groups.There were statistical differences among the three groups in age,length of hospital stay,heat stroke,fever peak,oral herpes,incidence of headache,convulsions and disturbance ofconsciousness,and time of nervous system involvement.Significance(P <0.05).There was no statistically significant difference among the three groups in the incidence of gender,personal history,past history,illness,fright,vomiting,Pakistani and meningeal irritation(P>0.05),the comparison between the two groups showed that the age of onset in the EV71 group was longer,hospitalization time,heat stroke,and nervous system involvement were longer,and the incidence of frightening,convulsions,and disturbance of consciousness was higher in the EV71 group than in the Cox A16 group;3)In the auxiliary examination(leukocyte,CRP,blood glucose,myocardial markers,transaminases,electroencephalogram),CRP,myocardial markers,transaminase levels,and EEG abnormalities were statistically significant among the three groups(P<0.05),Comparison of two groups showed CoxA16 group were higher than the other two groups in CK-MB,cTnI,ALT and AST levels.The abnormal rate of EEG in the EV71 group was higher than that in the other two groups.Conclusion:1)With the exception of EV71,severe HFMD caused by EUV should not be neglected;2)Herpes without oral herpes,persistent fever,incidence of frightened,convulsions and disturbance of consciousness can contribute to the diagnosis of EV71 infection,and at the same time,doctors must be alert to the legacy of neurological sequelae;3)The etiological detection of HFMD can help determine the condition andprognosis,and select appropriate examination methods for clinical diagnosis and treatment,and intervention;4)The proportion of EV71 in critical cases is higher,and the incidence of severe HFMD is mainly EV71.It is recommended to vaccinate EV71 vaccine to reduce the incidence and mortality of severe HFMD.