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Microbiology · Virology: enterovirus A71
Sample itemA 3-year-old child has hand, foot and mouth disease. Three days later he develops myoclonic jerks, ataxia, tremor, tachycardia and pulmonary oedema. Which agent is most likely to cause this complication?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Enterovirus A71
Enterovirus A71 is neurotropic and, in addition to typical hand, foot and mouth disease, can cause brainstem encephalitis with myoclonus, ataxia and autonomic instability leading to neurogenic pulmonary oedema. Coxsackie A16 usually causes a mild illness. Poliovirus-like acute flaccid paralysis can also occur with EV-A71.
Option by option
A. Enterovirus A71 (correct)
EV-A71 produces brainstem encephalitis and neurogenic pulmonary oedema after hand, foot and mouth disease.
B. Human herpesvirus 6
Human herpesvirus 6 causes roseola infantum with fever and rash.
C. Parechovirus A3
Parechovirus A3 causes sepsis-like illness and meningitis in young infants rather than HFMD with this pattern.
D. Coxsackievirus A16
Coxsackievirus A16 typically causes a mild self-limiting form of hand, foot and mouth disease.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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