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Acute flaccid myelitis associated with enterovirus-D68 infection in an otherwise healthy child

Overview of attention for article published in Virology Journal, January 2017
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (89th percentile)

Mentioned by

news
1 news outlet
twitter
7 tweeters
wikipedia
4 Wikipedia pages

Citations

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40 Dimensions

Readers on

mendeley
67 Mendeley
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Title
Acute flaccid myelitis associated with enterovirus-D68 infection in an otherwise healthy child
Published in
Virology Journal, January 2017
DOI 10.1186/s12985-016-0678-0
Pubmed ID
Authors

Susanna Esposito, Giovanna Chidini, Claudia Cinnante, Luisa Napolitano, Alberto Giannini, Leonardo Terranova, Hubert Niesters, Nicola Principi, Edoardo Calderini

Abstract

Reporting new cases of enterovirus (EV)-D68-associated acute flaccid myelitis (AFM) is essential to understand how the virus causes neurological damage and to characterize EV-D68 strains associated with AFM. A previously healthy 4-year-old boy presented with sudden weakness and limited mobility in his left arm. Two days earlier, he had an upper respiratory illness with mild fever. At admission, his physical examination showed that the child was febrile (38.5 °C) and alert but had a stiff neck and weakness in his left arm, which was hypotonic and areflexic. Cerebrospinal fluid (CSF) examination showed a mild increase in white blood cell count (80/mm(3), 41% neutrophils) and a slightly elevated protein concentration (76 gm/dL). Bacterial culture and molecular biology tests for detecting viral infection in CSF were negative. The patient was then treated with intravenous ceftriaxone and acyclovir. Despite therapy, within 24 h, the muscle weakness extended to all four limbs, which exhibited greatly reduced mobility. Due to his worsening clinical prognosis, the child was transferred to our Pediatric Intensive Care Unit; at admission he was diagnosed with acute flaccid paralysis of all four limbs. Brain magnetic resonance imaging (MRI) was negative, except for a focal signal alteration in the dorsal portion of the medulla oblongata, also involving the pontine tegmentum, whereas spine MRI showed an extensive signal alteration of the cervical and dorsal spinal cord reported as myelitis. Signal alteration was mainly localized in the central grey matter, most likely in the anterior horns. Molecular biology tests performed on nasopharyngeal aspirate and on bronchoalveolar lavage fluid were negative for bacteria but positive for EV-D68 clade B3. Plasmapheresis was performed and corticosteroids and intravenous immunoglobulins were administered. After 4 weeks of treatment, the signs and symptoms of AFM were significantly reduced, although some weakness and tingling remained in the patient's four limbs. MRI acquired after 3 weeks showed that the previously reported alterations were no longer present. This case suggests that EV-D68 is a neurotropic agent that can cause AFM and strains are circulating in Europe. EV-D68 disease surveillance is required to better understand EV-D68 pathology and to compare various strains that cause AFM.

Twitter Demographics

The data shown below were collected from the profiles of 7 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 67 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Netherlands 1 1%
Unknown 66 99%

Demographic breakdown

Readers by professional status Count As %
Researcher 10 15%
Other 9 13%
Student > Ph. D. Student 8 12%
Student > Bachelor 7 10%
Student > Doctoral Student 6 9%
Other 9 13%
Unknown 18 27%
Readers by discipline Count As %
Medicine and Dentistry 19 28%
Biochemistry, Genetics and Molecular Biology 7 10%
Agricultural and Biological Sciences 4 6%
Immunology and Microbiology 4 6%
Nursing and Health Professions 3 4%
Other 9 13%
Unknown 21 31%

Attention Score in Context

This research output has an Altmetric Attention Score of 17. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 December 2020.
All research outputs
#1,658,124
of 20,815,952 outputs
Outputs from Virology Journal
#115
of 2,871 outputs
Outputs of similar age
#40,456
of 387,453 outputs
Outputs of similar age from Virology Journal
#1
of 1 outputs
Altmetric has tracked 20,815,952 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,871 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.6. This one has done particularly well, scoring higher than 95% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 387,453 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 89% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them