Affiliations: Department of Pediatrics, Graduate School of Medicine,
Gifu University, Gifu, Japan | Center for Emerging Infectious Diseases (CEID), Gifu
University, Gifu, Japan | Center for Advanced Drug Research (CADR), Gifu
University, Gifu, Japan
Note: [] Correspondence: Zenichiro Kato, MD, Department of Pediatrics,
Graduate School of Medicine, Gifu University, Yanagido 1-1, Gifu 501-1194,
Japan. Tel.: +81 58 230 6386; Fax: +81 58 230 6387; E-mail:
zen-k@cc.gifu-u.ac.jp
Abstract: Acute disseminated encephalomyelitis is an immune-mediated
inflammatory demyelinating disease of the central nervous system that can occur
during or after infections. A 2-year-old female was hospitalized in an
unconsciousness state with fever. She had suffered from 5 days of
hand-foot-mouth disease until 2 days before admission. Magnetic resonance
imaging disclosed high-intensity lesions at the cerebrum and cerebellum but not
at the brainstem and spinal cord, confirming the diagnosis of acute
disseminated encephalomyelitis. Her illness was remarkably improved after the
start of steroid therapy and she could recover without any sequele. The genetic
analysis of the genome sequence revealed that the isolated strain was
enterovirus 71. The phylogenetic analysis with the strains obtained from fatal
brainstem encephalitis suggests an association between the genotypes and the
neurological virulency.
