ĐẶC ĐIỂM LÂM SÀNG VÀ CẬN LÂM SÀNG BỆNH TAY CHÂN MIỆNG CÓ BIẾN CHỨNG VIÊM NÃO Ở TRẺ EM TẠI BỆNH VIỆN NHI TRUNG ƯƠNG

Abstract

Encephalitis in hand, foot and mouth disease is a severe complication with an acute course and acute encephalitic syndrome, most commonly caused by Enterovirus 71. Aims: To describe the clinical and laboratory characteristics of hand, foot and mouth disease with encephalitis in children at the National Children’s Hospital. Materials and Methods: A descriptive study was conducted on 94 children diagnosed with hand, foot and mouth disease with encephalitis at the Center of Tropical Diseases, National Children’s Hospital, from January 2023 to July 2023. Results: The median age was 25.5 months, with a male-to-female ratio of 1.9/1. Patients were admitted mainly at grade IIB1 and IIB2 (both 37.2%). Most children had fever (97.9%), of which 53.2% had high fever ≥39°C. Typical mucocutaneous manifestations included rash on the palms (92.6%), soles (88.3%), and oral ulcers (51.1%). Neurological symptoms were prominent, with startle being the most common (94.7%), of which 81.9% experienced startle ≥2 times/30 minutes; other symptoms included limb tremor (57.4%), ataxia (41.5%), and irritability (72.3%). Peripheral leukocytosis and EV71 positivity were both recorded in 80.9% of cases. Cerebrospinal fluid findings were characterized by mononuclear pleocytosis, with protein and glucose within normal limits. Conclusion: Encephalitis due to hand, foot and mouth disease is common in boys under 3 years of age, presenting with fever, altered consciousness, and vesicular rash. Laboratory findings showed leukocytosis, EV71 positivity, and cerebrospinal fluid consistent with viral encephalitis.