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Zambian Study Finds Longer Breastfeeding Best for HIV-Infected Mothers

Syphilis Survey Reveals Need for Accurate Testing for Early Infection

15 June 2004

Volume 38, Number 12
Clinical Infectious Diseases 2004;38:1784–1788
© 2004 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2004/3812-0019$15.00
DOI: 10.1086/421021
BRIEF REPORT

Mechanism of Fulminant Pulmonary Edema Caused by Enterovirus 71

Shang Jyh Kao,1

Fwu Lin Yang,2

Yung Hsiang Hsu,3 and

Hsing I Chen4

1Department of Chest Medicine, Shin Kong Wu Ho‐Su Memorial Hospital, School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei; 2Division of Intensive Care Medicine, 3Department of Pathology, and 4Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan

Pulmonary edema (PE) may occur with enterovirus 71 (EV71) infection. We monitored arterial pressure (AP) and heart rate (HR) in patients with EV71 infection and analyzed the variability of AP and HR. Sympathetic activity, AP, and HR increased with respiratory stress. Thereafter, parasympathetic activity increased with decreases in AP and HR. The lungs showed edema with inducible nitric oxide synthase (iNOS) expression. Destruction of the medial, ventral, and caudal medulla may lead to sympathetic overactivation, causing blood to shift to the lungs. The pathogenesis of PE may also involve iNOS and nitric oxide.

Received 23 December 2003; accepted 23 February 2004; electronically published 19 May 2004.

Reprints or correspondence: Dr. Hsing I Chen, Institute of Medical Sciences, Tzu Chi University, 701, Section 3, Chung‐Yang Rd., Hualien 97004, Taiwan, Republic of China ().

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