BMC Infectious Diseases (Nov 2021)

A fatal case of acute encephalopathy in a child due to coxsackievirus A2 infection: a case report

  • Tomonori Nagai,
  • Nozomu Hanaoka,
  • Harutaka Katano,
  • Masami Konagaya,
  • Keiko Tanaka-Taya,
  • Hiroyuki Shimizu,
  • Toshiji Mukai,
  • Tsuguto Fujimoto

DOI
https://doi.org/10.1186/s12879-021-06858-2
Journal volume & issue
Vol. 21, no. 1
pp. 1 – 5

Abstract

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Abstract Background Certain types of enteroviruses, including coxsackieviruses, cause encephalitis, and other neurological complications. However, these pathogens rarely cause fatal infections, especially in immunocompetent infants. In this study, we present a rare case of acute encephalopathy caused by coxsackievirus A2 (CV-A2), which progressed rapidly in a previously healthy female child. Case presentation In June 2013, a 26-month-old female child from Kanagawa, Japan, was found unresponsive during sleep. She was healthy until that morning. Her temperature was 37 °C at 08:00. She was feeling fine and went to the nursery that same morning. However, her condition worsened around noon. Therefore, she went home and slept at around 13:00. Surprisingly, after 2 h, her parents checked on her and found that she was lying on her back and was not breathing. Hence, she was immediately taken to a hospital by ambulance, but she was declared dead on arrival at the hospital. Subsequently, pathological autopsy and pathogenetic analysis, including multiple pathogen detection real-time PCR, were conducted to investigate the cause of death. The examination results revealed that she had an infectious respiratory disease and acute encephalopathy due to a CV-A2 infection. Conclusions Based on our findings, we concluded that a previously healthy girl who had no immediate history of underlying medical condition were susceptible to death by acute encephalopathy due to CV-A2 infections. We proposed this conclusion because the patient’s condition progressed rapidly in less than 2 h and eventually led to her death. This is the first report on an acute encephalitis-dependent death in a child due to CV-A2 infection.

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