{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T09:04:31Z","timestamp":1758704671646},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2012,7,2]],"date-time":"2012-07-02T00:00:00Z","timestamp":1341187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathology International"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:p>A 15\u2010month boy with fatal hand, foot, and mouth disease (HFMD) exhibited atypical symptoms and progressed rapidly to death. An autopsy was performed the next day and tissue sections were stained for histopathological examination. His intestinal samples were tested for enterovirus 71 (EV71), and the whole\u2010genome sequence of EV71 was analyzed. An autopsy revealed that the central nervous system, lungs, and gut displayed severe meningitis and brainstem encephalitis, remarkable pulmonary congestion, edema, moderate inflammatory infiltration, and hemorrhage as well as intestinal mucosal congestion, epithelial necrosis, thinning intestinal wall, and submucosal lymphoid follicular hyperplasia. The heart showed myocardial interstitial congestion, myocardial edema, and some inflammatory infiltrates. There were no significant alterations in the architecture of other organs. EV71 antigen and apoptotic cells were detected in brain, lung and intestine by immunohistochemical staining and TUNEL (TdT\u2010mediated dUTP nick\u2010end labeling) respectively. Intestinal contents and intestinal autopsy samples of this case were positive for EV71, and the EV71 strain was classified as subgenogroup C4. In China, the severe forms of HFMD were mostly caused by EV71 subgenogroup C4 infection. Severe intestinal damages may relate to EV71 subgenogroup C4 infection. Thus, children with severe EV71 HFMD may have serious pathological changes in their central nervous system, lungs, and gut. Physicians should pay special attention to infants with atypical symptoms, particularly in EV71 epidemic areas for early diagnosis and treatment.<\/jats:p>","DOI":"10.1111\/j.1440-1827.2012.02837.x","type":"journal-article","created":{"date-parts":[[2012,7,2]],"date-time":"2012-07-02T13:43:10Z","timestamp":1341236590000},"page":"565-570","source":"Crossref","is-referenced-by-count":26,"title":["Clinicopathologic features and molecular analysis of enterovirus 71 infection: Report of an autopsy case from the epidemic of hand, foot and mouth disease in China"],"prefix":"10.1111","volume":"62","author":[{"given":"Yue\u2010Can","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su\u2010Wen","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen\u2010Zhen","family":"Gu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ai\u2010Rong","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuan\u2010Tong","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao\u2010Yue","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao\u2010Ren","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"De\u2010Dong","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,7,2]]},"reference":[{"key":"e_1_2_5_2_2","first-page":"118","article-title":"Epidemiological study and clinical analysis of patients with hand,foot and mouth disease in eastern Zhejiang province in past 3\u2003years","volume":"3","author":"Liang XY","year":"2010","journal-title":"Zhong Hua Lin Chuang Gan Ran Bing Za Zhi"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199912000-00013"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.73.12.9969-9975.1999"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.75.16.7732-7738.2001"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1086\/511073"},{"key":"e_1_2_5_7_2","first-page":"297","article-title":"Deaths in children during an outbreak of hand, foot and mouth disease in Peninsular Malaysia\u2013clinical and pathological characteristics","volume":"60","author":"Shekhar K","year":"2005","journal-title":"Med J Malaysia"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1511.090493"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.3880222"},{"key":"e_1_2_5_10_2","first-page":"220","article-title":"Autopsy report of two cases with enterovirus type 71 infection brainstem encephalitis and literature review","volume":"48","author":"Wei D","year":"2010","journal-title":"Zhong Hua Er Ke Za Zhi"},{"key":"e_1_2_5_11_2","first-page":"258","article-title":"Molecular confirmation of enterovirus type 71 infection: A post\u2010mortem study of two cases","volume":"38","author":"Yang Y","year":"2009","journal-title":"Zhong Hua Bing Li Xue Za Zhi"},{"key":"e_1_2_5_12_2","first-page":"81","article-title":"Pathology of enterovirus 71 infection: An autopsy study of 5 cases","volume":"38","author":"Lu M","year":"2009","journal-title":"Zhong Hua Bing Li Xue Za Zhi"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12250-010-3102-8"},{"key":"e_1_2_5_14_2","first-page":"729","article-title":"Genetic characterization of enterovirus 71 complete genome isolated in Beijing, 2008","volume":"30","author":"Yao X","year":"2009","journal-title":"Zhong Hua Liu Xing Bing Xue Za Zhi"},{"key":"e_1_2_5_15_2","first-page":"7","article-title":"The complete genome sequencing of enterovirus 71 (EV71) SHZH03 strain isolated in China","volume":"20","author":"Zhou SL","year":"2004","journal-title":"Bing Du Xue Bao"},{"key":"e_1_2_5_16_2","doi-asserted-by":"crossref","first-page":"229","DOI":"10.7883\/yoken.63.229","article-title":"Clinical and molecular characterization of hand\u2010foot\u2010and\u2010mouth disease in Thailand, 2008\u20132009","volume":"63","author":"Chatproedprai S","year":"2010","journal-title":"Jpn J Infect Dis"},{"key":"e_1_2_5_17_2","first-page":"24","article-title":"Clinical characteristics and treatment assessments of severe enterovirus 71 infected children","volume":"48","author":"Liu JT","year":"2010","journal-title":"Zhong Hua Er Ke Za Zhi"},{"key":"e_1_2_5_18_2","unstructured":"Ministry of Health of the People's Republic of China.Strategy for the diagnosis and treatment of patients with hand foot and mouth disease.2010. 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