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Pereverzev AP, Pereverzeva AS, Popadyuk VI, Ostroumova OD. [Herpangina. Clinical case]. Vestn Otorinolaringol 2021; 86:97-102. [PMID: 34783481 DOI: 10.17116/otorino20218605197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Enterovirus infections are a group of acute infectious diseases caused by enteroviruses (including Coxsackie A and B viruses, ECHO viruses), which clinically present symptoms of damage to the central nervous system, cardiovascular system, gastrointestinal tract, muscular system, mucous membranes and skin, fever. This article presents a clinical case of patient L., 12 years old, who admitted to an otorhinolaryngologist with clinical manifestations of herpangina. The diagnosis was confirmed by PCR. The patient was prescribed, adequate rehydration, diet with the exclusion of salty, spicy and fried foods, restriction of physical activity, exclusion of thermal procedures, Benzydamine Spray (Oralsept) 0.255 mg/dose, 6 doses 3 times/day, topically, on demand and inosine pranobex (Groprinosin) in a daily dose of 50 mg/kg of body weight: 1 tablet 500 mg 4 times a day for 7 days (at the rate of 1 tablet of 500 mg per 10 kg of body weight; for a patient weighing 41 kg - 4 tablets per day). On the 10th day from the onset of the disease, the docter noted a complete regression of clinical symptoms and the patient was discharged with recovery.
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Affiliation(s)
- A P Pereverzev
- Russian Medical Academy for Continuous Professional Education, Moscow, Russia
| | | | - V I Popadyuk
- Peoples' Friendship University of Russia, Moscow, Russia
| | - O D Ostroumova
- Russian Medical Academy for Continuous Professional Education, Moscow, Russia.,Sechenov First Moscow State Medical University, Moscow, Russia
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Song Y, Zhang Y, Han Z, Xu W, Xiao J, Wang X, Wang J, Yang J, Yu Q, Yu D, Chen J, Huang W, Li J, Xie T, Lu H, Ji T, Yang Q, Yan D, Zhu S, Xu W. Genetic recombination in fast-spreading coxsackievirus A6 variants: a potential role in evolution and pathogenicity. Virus Evol 2020; 6:veaa048. [PMID: 34804589 PMCID: PMC8597624 DOI: 10.1093/ve/veaa048] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Hand, foot, and mouth disease (HFMD) is a common global epidemic. From 2008
onwards, many HFMD outbreaks caused by coxsackievirus A6 (CV-A6) have been
reported worldwide. Since 2013, with a dramatically increasing number of
CV-A6-related HFMD cases, CV-A6 has become the predominant HFMD pathogen in
mainland China. Phylogenetic analysis based on the VP1 capsid
gene revealed that subtype D3 dominated the CV-A6 outbreaks. Here, we performed
a large-scale (near) full-length genetic analysis of global and Chinese CV-A6
variants, including 158 newly sequenced samples collected extensively in
mainland China between 2010 and 2018. During the global transmission of subtype
D3 of CV-A6, the noncapsid gene continued recombining, giving rise to a series
of viable recombinant hybrids designated evolutionary lineages, and each lineage
displayed internal consistency in both genetic and epidemiological features. The
emergence of lineage –A since 2005 has triggered CV-A6 outbreaks
worldwide, with a rate of evolution estimated at
4.17 × 10−3 substitutions
site-1 year−1 based on a
large number of monophyletic open reading frame sequences, and created a series
of lineages chronologically through varied noncapsid recombination events. In
mainland China, lineage –A has generated another two novel widespread
lineages (–J and –L) through recombination within the
enterovirus A gene pool, with robust estimates of occurrence time. Lineage
–A, –J, and –L infections presented dissimilar clinical
manifestations, indicating that the conservation of the CV-A6 capsid gene
resulted in high transmissibility, but the lineage-specific noncapsid gene might
influence pathogenicity. Potentially important amino acid substitutions were
further predicted among CV-A6 variants. The evolutionary phenomenon of noncapsid
polymorphism within the same subtype observed in CV-A6 was uncommon in other
leading HFMD pathogens; such frequent recombination happened in fast-spreading
CV-A6, indicating that the recovery of deleterious genomes may still be ongoing
within CV-A6 quasispecies. CV-A6-related HFMD outbreaks have caused a
significant public health burden and pose a great threat to children’s
health; therefore, further surveillance is greatly needed to understand the full
genetic diversity of CV-A6 in mainland China.
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Affiliation(s)
- Yang Song
- WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, China
| | - Yong Zhang
- WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, China.,Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei Province, China
| | - Zhenzhi Han
- WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, China
| | - Wen Xu
- Yunnan Center for Disease Control and Prevention, Kunming, Yunnan Province, China
| | - Jinbo Xiao
- WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, China
| | - Xianjun Wang
- Shandong Center for Disease Control and Prevention, Jinan, Shandong Province, China
| | - Jianxing Wang
- Shandong Center for Disease Control and Prevention, Jinan, Shandong Province, China
| | - Jianfang Yang
- Shanxi Center for Disease Control and Prevention, Taiyuan, Shanxi Province, China
| | - Qiuli Yu
- Hebei Center for Disease Control and Prevention, Shijiazhuang, Hebei Province, China
| | - Deshan Yu
- Gansu Center for Disease Control and Prevention, Lanzhou, Gansu Province, China
| | - Jianhua Chen
- Gansu Center for Disease Control and Prevention, Lanzhou, Gansu Province, China
| | - Wei Huang
- Chongqing Center for Disease Control and Prevention, Chongqing City, China
| | - Jie Li
- Beijing Center for Disease Control and Prevention, Beijing City, China
| | - Tong Xie
- Tianjin Center for Disease Control and Prevention, Tianjin City, China
| | - Huanhuan Lu
- WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, China
| | - Tianjiao Ji
- WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, China
| | - Qian Yang
- WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, China
| | - Dongmei Yan
- WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, China
| | - Shuangli Zhu
- WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, China
| | - Wenbo Xu
- WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, 102206, China.,Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei Province, China.,Anhui University of Science and Technology, Anhui Province, China
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