{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T11:53:01Z","timestamp":1783943581717,"version":"3.55.0"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T00:00:00Z","timestamp":1637193600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T00:00:00Z","timestamp":1637193600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["19HA1002"],"award-info":[{"award-number":["19HA1002"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Certain types of enteroviruses, including coxsackieviruses, cause encephalitis, and other neurological complications. However, these pathogens rarely cause fatal infections, especially in immunocompetent infants. In this study, we present a rare case of acute encephalopathy caused by coxsackievirus A2 (CV-A2), which progressed rapidly in a previously healthy female child.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>In June 2013, a 26-month-old female child from Kanagawa, Japan, was found unresponsive during sleep. She was healthy until that morning. Her temperature was 37\u00a0\u00b0C at 08:00. She was feeling fine and went to the nursery that same morning.\u00a0However, her condition worsened around noon. Therefore, she went home and slept at around 13:00. Surprisingly, after 2\u00a0h, her parents checked on her and found that she was lying on her back and was not breathing. Hence, she was immediately taken to a hospital by ambulance, but she was declared dead on arrival at the hospital. Subsequently, pathological autopsy and pathogenetic analysis, including multiple pathogen detection real-time PCR, were conducted to investigate the cause of death. The examination results revealed that she had an infectious respiratory disease and acute encephalopathy due to a CV-A2 infection.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Based on our findings, we concluded that a previously healthy girl who had no immediate history of underlying medical condition were susceptible to death by acute encephalopathy due to CV-A2 infections. We proposed this conclusion because the patient\u2019s condition progressed rapidly in less than 2\u00a0h and eventually led to her death. This is the first report on an acute encephalitis-dependent death in a child due to CV-A2 infection.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-06858-2","type":"journal-article","created":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T12:03:12Z","timestamp":1637236992000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["A fatal case of acute encephalopathy in a child due to coxsackievirus A2 infection: a case report"],"prefix":"10.1186","volume":"21","author":[{"given":"Tomonori","family":"Nagai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nozomu","family":"Hanaoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harutaka","family":"Katano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masami","family":"Konagaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Tanaka-Taya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiji","family":"Mukai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4861-4349","authenticated-orcid":false,"given":"Tsuguto","family":"Fujimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,18]]},"reference":[{"key":"6858_CR1","first-page":"86","volume-title":"Fields virology","author":"CB Coyne","year":"2021","unstructured":"Coyne CB, Oberste MS, Pallansch MA. Enteroviruses: polioviruses, coxsackieviruses, echoviruses, and newer enteroviruses. In: Howley PM, Knipe DM, editors. Fields virology. 7th ed. Philadelphia: Wolters Kluwer, Lippincott Williams & Wilkins; 2021. p. 86\u2013128.","edition":"7"},{"key":"6858_CR2","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/S1684-1182(10)60016-3","volume":"43","author":"SP Chen","year":"2010","unstructured":"Chen SP, Huang YC, Li WC, Chiu CH, Huang CG, Tsao KC, et al. Comparison of clinical features between coxsackievirus A2 and enterovirus 71 during the enterovirus outbreak in Taiwan, 2008: a children\u2019s hospital experience. J Microbiol Immunol Infect. 2010;43:99\u2013104. https:\/\/doi.org\/10.1016\/S1684-1182(10)60016-3.","journal-title":"J Microbiol Immunol Infect"},{"key":"6858_CR3","first-page":"1","volume":"55","author":"N Khetsuriani","year":"2006","unstructured":"Khetsuriani N, Lamonte-Fowlkes A, Oberst S, Pallansch MA, Centers for disease control and prevention. Enterovirus surveillance\u2014United States, 1970\u20132005. MMWR Surveill Summ. 2006;55:1\u201320.","journal-title":"MMWR Surveill Summ"},{"key":"6858_CR4","doi-asserted-by":"publisher","first-page":"117","DOI":"10.11150\/kansenshogakuzasshi1970.79.117","volume":"79","author":"K Yamazaki","year":"2005","unstructured":"Yamazaki K, Otake T. A study on enterovirus infection in Osaka prefecture\u2014comparison with virus isolation and RT-PCR amplifying viral protein 1 region. Kansenshogaku Zasshi. 2005;79:117\u201321. https:\/\/doi.org\/10.11150\/kansenshogakuzasshi1970.79.117 (in Japanese).","journal-title":"Kansenshogaku Zasshi"},{"key":"6858_CR5","doi-asserted-by":"publisher","first-page":"5201","DOI":"10.3390\/ijms20205201","volume":"20","author":"G Gonzalez","year":"2019","unstructured":"Gonzalez G, Carr MJ, Kobayashi M, Hanaoka N, Fujimoto T. Enterovirus-associated hand-foot and mouth disease and neurological complications in Japan and the rest of the world. Int J Mol Sci. 2019;20:5201. https:\/\/doi.org\/10.3390\/ijms20205201.","journal-title":"Int J Mol Sci"},{"key":"6858_CR6","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1016\/j.jmii.2016.08.012","volume":"50","author":"TY Yen","year":"2017","unstructured":"Yen TY, Huang YP, Hsu YL, Chang YT, Lin HC, Wu HS, et al. A case of recombinant coxsackievirus A2 infection with neurological complications in Taiwan. J Microbiol Immunol Infect. 2017;50:928\u201330. https:\/\/doi.org\/10.1016\/j.jmii.2016.08.012.","journal-title":"J Microbiol Immunol Infect"},{"key":"6858_CR7","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1002\/jmv.1075","volume":"64","author":"JW Bendig","year":"2001","unstructured":"Bendig JW, O\u2019Brien PS, Muir P, Porter HJ, Caul EO. Enterovirus sequences resembling coxsackievirus A2 detected in stool and spleen from a girl with fatal myocarditis. 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BMC Infect Dis. 2019;19:1\u201310.","journal-title":"BMC Infect Dis"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06858-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-021-06858-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06858-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T12:03:17Z","timestamp":1637236997000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-021-06858-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,18]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["6858"],"URL":"https:\/\/doi.org\/10.1186\/s12879-021-06858-2","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,18]]},"assertion":[{"value":"27 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The ethics review board of the National Institute of Infectious Diseases (No. 445) approved this case report for publication.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from parents for the patient under 18 years old. The parents gave their written consent for their child\u2019s personal or clinical details along with any identifying images to be published in this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1167"}}