{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:51:20Z","timestamp":1790815880687,"version":"4.1.0"},"reference-count":19,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,10,27]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:p>Enterovirus D68 (EV-D68) causes respiratory illnesses such as pneumonia, and has been reported to cause acute flaccid myelitis. Enterovirus A71 (EV-A71) is known to cause cardiopulmonary failure due to brainstem encephalitis, but there have been few reports of these conditions being associated with EV-D68. Outbreaks of EV-D68 infection have occurred in the USA, Canada, Europe and Asia. Clinical management is largely supportive and there are no specific antivirals available. The case patient, a 4-year-old girl, had cardiopulmonary failure due to brainstem encephalitis. EV-D68 was isolated from a throat swab. On admission, she had cardiopulmonary failure, which required intensive care using a ventilator and inotropic agents. Her cardiac function improved, but she had residual bulbar paralysis and limb weakness, which resolved over a 6-month period. This case confirms that EV-D68, may cause severe illness due to brainstem encephalitis, similar to that caused by EV-A71.<\/jats:p>","DOI":"10.1136\/bcr-2019-231990","type":"journal-article","created":{"date-parts":[[2019,11,15]],"date-time":"2019-11-15T07:25:20Z","timestamp":1573802720000},"page":"e231990","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Cardiopulmonary failure as a result of brainstem encephalitis caused by enterovirus D68"],"prefix":"10.1136","volume":"12","author":[{"given":"Naoki","family":"Yogo","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiko","family":"Imamura","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Muto","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuki","family":"Hirai","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,11,14]]},"reference":[{"key":"2025082723214207000_12.11.e231990.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(10)70194-8"},{"key":"2025082723214207000_12.11.e231990.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)00543-5"},{"key":"2025082723214207000_12.11.e231990.3","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1017\/S0950268818000468","article-title":"Factors associated with fatal outcome of children with enterovirus A71 infection: a case series","volume":"146","author":"Yang","year":"2018","journal-title":"Epidemiol Infect"},{"key":"2025082723214207000_12.11.e231990.4","doi-asserted-by":"crossref","unstructured":"Messacar K , Abzug MJ , Dominguez SR . 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