Background There are few reports on the timing of onset and the symptoms of enterovirus A71 (EV-A71) infection, which can easily be misdiagnosed. This study aimed to explore the clinical characteristics of children with severe EV-A71 infection. Methods This retrospective observational study included children with severe EV-A71 infection admitted to Hebei Children’s Hospital between January 2016 and January 2018. Results A total of 101 patients were included: 57 males (56.4%) and 44 females (43.6%). They were 1–13 years of age. The symptoms were fever in 94 patients (93.1%), rash in 46 (45.5%), irritability in 70 (69.3%), and lethargy in 56 (55.4%). There were 19 (59.3%) patients with abnormal neurological magnetic resonance imaging [pontine tegmentum (n = 14, 43.8%), medulla oblongata (n = 11, 34.4%), midbrain (n = 9, 28.1%), cerebellum and dentate nucleus (n = 8, 25.0%), basal ganglia (n = 4, 12.5%), cortex (n = 4, 12.5%), spinal cord (n = 3, 9.3%), and meninges (n = 1, 3.1%)]. There was a positive correlation between the ratio of neutrophil count and white blood cell count in cerebrospinal fluid in the first 3 days of the disease (r = 0.415, P < 0.001). Conclusion The clinical symptoms of EV-A71 infection are fever and/or skin rash, irritability, and lethargy. Some patients have abnormal neurological magnetic resonance imaging. The white blood cell count in the cerebrospinal fluid of children with EV-A71 infection may increase alongside neutrophil counts.

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Background There are few reports on the timing of onset and characteristics of the symptoms of enterovirus 71 (EV71) infection, which can easily be misjudged by clinicians. This study is aimed to explore the clinical characteristics of children with severe EV71 infection. Methods This retrospective observational study included children with severe EV71 infection who were admitted to Hebei Children’s Hospital between January 2016 and January 2018. Results A total of 101 patients were enrolled, with 57 males (56.4%) and 44 females (43.6%). They were 1–13 years of age. The symptoms were fever in 94 patients (93.1%), rash in 46 (45.5%), a susceptible mood in 70 (69.3%), and lethargy in 56 (55.4%). There were 19 (59.3%) cases with abnormal neurological magnetic resonance imaging [pontine tegmentum (n = 14, 43.8%), medulla oblongata (n = 11, 34.4%), midbrain (n = 9, 28.1%), cerebellum and dentate nucleus (n = 8, 25.0%), basal ganglia (n = 4, 12.5%), cortex (n = 4, 12.5%), spinal cord (n = 3, 9.3%), and meninges]. There was a positive correlation between the ratio of neutrophil count and white blood cell count in CSF in the first 3 days of the course of the disease (r = 0.415, P < 0.001). Conclusion The clinical symptoms of EV71 infection are fever and/or skin rash, easy convulsion, and lethargy. Some patients were with abnormal neurological magnetic resonance imaging. The white blood cell count in the cerebrospinal fluid of children with EV71 infection may increase with the ratio of peripheral blood neutrophils in the cerebrospinal fluid of children with EV71 infection.