211.2 📚 國考版

211.2.0.1 必背 — Groups

  • Poliovirus, Coxsackie A + B, Echovirus, EV-71, EV-D68

211.2.0.2 必背 — Aseptic Meningitis

  • Enteroviruses = #1 cause (Echo + Coxsackie B)
  • Summer + fall
  • Lymphocytic CSF, normal glucose
  • CSF PCR diagnostic

211.2.0.3 必背 — HFMD

  • Coxsackie A16 typical
  • EV-71 severe (Asia/Taiwan)
  • Children < 5 yr
  • Oral + hand + foot + buttock vesicles
  • Self-limited (A16); EV-71 → brainstem encephalitis + pulmonary edema

211.2.0.4 必背 — Pleurodynia + Myocarditis

  • Coxsackie B
  • Pleurodynia: chest pain (“devil’s grip”)
  • Myocarditis: chest pain + heart failure; can progress to DCM

211.2.0.5 必背 — Polio

  • 3 serotypes; type 1 wild in Pakistan + Afghanistan only (2024)
  • cVDPV2 outbreaks in vaccine-gap regions
  • 2022 NYS USA paralytic case = wake-up call
  • IPV (Salk) inactivated vs OPV (Sabin) oral attenuated

211.2.0.6 必背 — Post-Polio Syndrome

  • 30-40 yr after acute polio
  • New weakness + fatigue + atrophy
  • Motor neuron exhaustion

211.2.0.7 必背 — EV-71 + Taiwan

  • 1998 Taiwan outbreak — 78 deaths
  • Severe HFMD: brainstem encephalitis + pulmonary edema
  • Vaccines licensed (Vigoo, Sinovac, Taiwan)

211.2.0.8 必背 — Acute Flaccid Myelitis

  • EV-D68 + EV-71
  • Post-respiratory illness
  • Polio-like paralysis
  • MRI: cervical cord gray matter

211.2.0.9 必背 — Neonatal Enteroviral Sepsis

  • < 14 days old
  • Severe multi-organ
  • Mortality 5-10%
  • IVIG considered