Clinical diagnosis, treatment and etiology of 3 452 cases of severe hand foot mouth disease

Objective\r\nTo summarize the clinical experience and etiological analysis of critical hand, foot and mouth disease (HFMD).\r\n\r\n\r\nMethods\r\nA total of 3 452 children with HFMD admitted to the Department of Infection of Children’s Hospital of Kunming from April 2008 to December 2017 were selected, all children expressed hypertension symptoms. According to the onset time of hypertension, all children were divided into 3 groups. Twelve children in group A did not receive antihypertensive treatment for insufficient knowledge of hypertension; 1 257 children in group B were treated with phentolamine; 2 183 children in group C were treated with valproate sodium for hypertension. All children were given routine treatment for encephalitis, and 2 249 children (65.15%) were treated with intravenous gamma globulin.\r\n\r\n\r\nResults\r\nOf the 12 children in group A, 11 cases (91.67%) used ventilation and 5 cases (41.67%) died. Among the 1 257 children in group B, 46 cases (3.66%) used ventilation, and 13 cases (1.03%) died. Thirty-five cases (3.66%) of 2 183 children in group C used ventilation, however, 5 cases (0.23%) died. The pathogen mainly was EV71.\r\n\r\n\r\nConclusions\r\nEV71 is the main pathogen of severe HFMD. The severity of hypertension in children with HFMD is positively correlated with their disease condition. At the same time, active treatment of hypertension is one of the most important measures to rescue severe HFMD, and is the key to minimize the mortality and disability rate of severe HFMD.\r\n\r\n\r\nKey words: \r\nHand foot and mouth disease in children; Severe; Hypertension; Etiology; Treatment