Enterovirus Infection Symptoms and Complications in Children

General Clinical Presentation

Fever is typically the first symptom, usually low-grade but can exceed 102.2°F (39°C), often accompanied by malaise, general discomfort, and irritability 1
Respiratory symptoms including cough, rhinitis, and sore throat are frequently present 1
Gastrointestinal symptoms such as nausea, vomiting, diarrhea, and poor feeding occur commonly 1
Rash appears in approximately 37% of cases, presenting as small pink macules that evolve to vesicular lesions with characteristic distribution on palms, soles, and oral mucosa in hand, foot, and mouth disease 1

Aseptic meningitis is more common than encephalitis in enterovirus infections 2, 3
Meningoencephalitis with disturbances in consciousness and seizures 2
Enterovirus 71 rhombencephalitis in children presents with myoclonus, tremors, ataxia, and cranial nerve defects 2, 3
Acute flaccid myelitis (AFM) causes rapid limb weakness with low muscle tone, particularly associated with Enterovirus-D68 and Enterovirus-71 4
Neurogenic pulmonary edema can occur with Enterovirus-71 rhombencephalitis, potentially leading to fatal cardiorespiratory collapse 4

Chronic enteroviral meningoencephalitis occurs in children with agammaglobulinemia (rare) 2, 3
These patients may require intravenous immunoglobulin or intraventricular gamma-globulin for chronic and/or severe disease 2, 3