RT Journal Article SR Electronic T1 Cardiopulmonary failure as a result of brainstem encephalitis caused by enterovirus D68 JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e231990 DO 10.1136/bcr-2019-231990 VO 12 IS 11 A1 Naoki Yogo A1 Tomohiko Imamura A1 Yuichiro Muto A1 Katsuki Hirai YR 2019 UL http://casereports.bmj.com/content/12/11/e231990.abstract AB Enterovirus D68 (EV-D68) causes respiratory illnesses such as pneumonia, and has been reported to cause acute flaccid myelitis. Enterovirus A71 (EV-A71) is known to cause cardiopulmonary failure due to brainstem encephalitis, but there have been few reports of these conditions being associated with EV-D68. Outbreaks of EV-D68 infection have occurred in the USA, Canada, Europe and Asia. Clinical management is largely supportive and there are no specific antivirals available. The case patient, a 4-year-old girl, had cardiopulmonary failure due to brainstem encephalitis. EV-D68 was isolated from a throat swab. On admission, she had cardiopulmonary failure, which required intensive care using a ventilator and inotropic agents. Her cardiac function improved, but she had residual bulbar paralysis and limb weakness, which resolved over a 6-month period. This case confirms that EV-D68, may cause severe illness due to brainstem encephalitis, similar to that caused by EV-A71.