Table 2.
Clinical characteristics of deaths caused by hand foot and mouth disease in Vietnam 2011
| Characteristic | No. of cases/total (%) |
|---|---|
|
Symptoms recorded at admission in terminal hospital |
|
| Fever |
165/169 (98) |
| Myoclonus |
87/131 (66) |
| Vomiting |
70/131 (53) |
| Oral ulcers |
60/119 (50) |
| Vesicular erythema |
62/125 (50) |
| Diarrhea |
11/114 (10) |
| Shock |
74/169 (44) |
| Respiratory failure/cyanosis |
69/169 (41) |
| Pulmonary edema |
37/169 (22) |
| Apnea /Dyspnea |
14/169 (8) |
|
Highest clinical grade recorded at admission in terminal hospital |
|
| 1 |
10/158 (6) |
| 2a |
53/158 (34) |
| 2b |
26/158 (17) |
| 3 or 4 |
63/158 (40) |
| Misdiagnosis |
6/158 (4) |
|
Laboratory results during hospitalization |
|
| White blood cell count > 16000/mm3* |
106/142 (75) |
| Blood sugar > 180 mg/dL* |
76/142 (54) |
| Severe Metabolic acidosis |
69/140 (49) |
| Troponin I (+) |
63/142 (44) |
| Platelet > 400,000/mm3* |
57/142 (40) |
|
EV test results |
|
| EV71 |
84/103 (82) |
| EV |
16/103 (16) |
|
Main causes of death |
|
| Respiratory failure |
123/150 (82) |
| Prolonged shock |
104/150 (69) |
| Coma |
83/150 (55) |
| Ventricular fibrillation |
11/150 (7) |
| Others (heart failure, cerebral edema ect.) |
17/150 (11) |
|
Treatment |
|
| Vasoactive drugs |
|
| Dobutamine |
153/169 (91) |
| Adrenaline |
102/169 (60) |
| Noradrenaline |
51/169 (30) |
| Dopamine |
26/169 (15) |
| Intravenous immunoglobulin |
159/169 (94) |
| Hemofiltration | 35/169 (21) |
*Normal range:
- White blood cell count (4,300-10,800/mm3).
- Blood sugar (70–130 mg/dl).
- Platelet (100,000-300,000/mm3).