Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
권호 표지

A Case of Acute Disseminated Encephalomyelitis by Enterovirus 71

Enterovirus 71에 의한 급성 파종성 뇌척수염 1례

  • Hwang, Hui Sung (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Cho, Sung Hee (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Sun Mi (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Jung, Dae Chul (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Chung, Seung Yun (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kang, Jin Han (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
  • 황희승 (가톨릭대학교 의과대학 소아과학교실) ;
  • 조성희 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김선미 (가톨릭대학교 의과대학 소아과학교실) ;
  • 정대철 (가톨릭대학교 의과대학 소아과학교실) ;
  • 정승연 (가톨릭대학교 의과대학 소아과학교실) ;
  • 강진한 (가톨릭대학교 의과대학 소아과학교실)
  • Published : 2003.05.31
Download PDF
⟨ Previous Next ⟩

Abstract

Acute transverse myelitis is a focal inflammatory disorder of the spinal cord, resulting in motor, sensory, and autonomic dysfunction which would be the initial manifestation of acute disseminated encephalomyelitis. A 7-year-old boy developed weakness of lower extremities associated with dizziness and urinary dysfunction after upper respiratory infection. He showed gradual decreased mental status with respiratory difficulty. Spinal MRI showed diffuse spinal cord swelling from C3 to C7 levels with high signal intensity lesion on T2-weighted image, which is involved central gray matter of spinal cord from C3 to C7, proximal portion to cervicomedullary junction, and distal portion to the cornus medullaris. After the supplement of high dose intravenous methylprednisolone therapy with ventilator care, he showed gradual improvement. The brain MRI after extubation showed multifocal high signal intensity lesions in bilateral cerebral white matter on axial T2-weighted image. Immunoserologic test(neutral antibody test) for enterovirus 71 was positive. Dysfunction of the bladder lasted for 33 days. We report a case of transverse myelitis which progressed to acute disseminated encephalomyelitis by enterovirus 71 in a 7-year-old boy with related literatures.

본 저자들은 상기도 감염 후 발열과 배뇨곤란, 하지의 근력저하를 주소로 내원한 7세 환아에서, 급성 횡단성 척수염 증상으로 시작하여 의식 변화와 호흡부전의 급성 파종성 뇌척수염으로 진행한 1례에서 enterovirus 71을 증명하고 고용량 methylprednisolone 정주 후 증상의 호전을 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Keywords