Title: Severe hand-foot-mouth disease:a report of 3 autopsied cases
Abstract: Purpose To investigate the clinicopathological features of severe hand-foot-mouth disease by autopsy,and to analyze the cause of the patient's dead.Methods Autopsies were performed on three cases of severe hand-foot-mouth disease,the pathological changes were studied by light microscopy,the correlation between the pathological changes and the clinical signs and symptoms was analyzed,and the reasons resulting in the death of patients were discussed.Results Severe hand-foot-mouth disease occurred suddenly and progressed rapidly with a short duration.The patients presented with hand,foot and mouth vesicular eruptions and sudden onset of respiratory failure accompanied by nervous system manifestations.The mainly involved organs were the medulla oblongata,brain stem and the lung.The brain stem and the medulla oblongata exhibited the degeneration and necrosis of the neurons,encephalomalacia,lymphocytic infiltration around the vessels,neuronophagia and the formation of glial cell nodules,which was consistent with the viral encephalitis.The lung showed the widening of alveolar septa,the congestion of capillaries and the infiltration of a large number of macrophages,which also effused into the alveolar space,resulting in focal lung consolidation.The exudate in the alveolar space and the hyaline membrane were focally present.Focal pulmonary infarction was observed due to the pulmonary embolism.The changes in the lung were consistent with the interstitial pneumonia and acute pulmonary edema.Additionally,the lymph nodes and the spleen showed structural destruction by showing the follicular atrophy and the karyorrhexis of the cells in the follicular center,or a burning-out feature.Conclusions In the severe hand-foot-mouth disease,the virus not only involves the skin and oral mucosa,but also the medulla oblongata,brain stem and the lung,resulting in the viral encephalitis,viral pneumonia and neurogenic pulmonary edema,and consequently leading to the respiratory failure,which is responsible for the patient's death.
Publication Year: 2011
Publication Date: 2011-01-01
Language: en
Type: article
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Cited By Count: 3
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