Risk Factors of Chang et al for Pulmonary Edema in Patients with Hand, Foot, and Mouth Disease Caused by Enterovirus 71

 

NOTE: The authors for this paper are the same as the previous paper, which was written 3 years after this paper.

 

Pulmonary edema developed in patients who developed CNS involvement.

 

For patients with CNS involvement, the following risk factors for development of pulmonary edema were identified:

(1) hyperglycemia on admission (> 8.3 mmol/L, or >= 150 mg/dL)

(2) leukocytosis on admission (> 17,500 per µL)

(3) upper and/or lower limb weakness

 

Hyperglycemia was the most important prognostic factor for development of pulmonary edema in patients with CNS involvement on multivariate analysis.

 

NOTE: The authors used a staging system for enterovirus 71 infections, which appears to have been supplanted by the staging scheme in the previous section. The first 2 stages are similar but the latter 2 differ significantly.

Stage	Clinical Features
1	hand-foot-mouth disease (HFMD) or herpangina or fever
2	encephalomyelitis, with limb weakness, lethargy, headache, vomiting, upward gaze, seizures
3	autonomic nervous system dysfunction with neurogenic bladder, paralytic ileus, insomnia, profuse sweating, hyperglycemia, leukocytosis, and tachycardia
4	pulmonary edema with tachypnea, hypoxia and shock

from page 1686.