M.D.
Nguyen Nhat Duy

Title: Neurologic Complications of Severe Hand, Foot and Mouth Disease: Emergency Warning Signs and ICU Outcomes in Vietnam

Name(s): Nguyen Nhat Duy, MD; Nguyen Van Trinh, MD; Pham Ngoc Thuy Tien, MS. Vo Van Thi, MD, MSc Can Tho University of Medicine and Pharmacy.

Severe hand, foot and mouth disease (HFMD) may deteriorate rapidly with neurologic involvement and cardio-respiratory instability. We aimed to identify emergency warning signs associated with severe neurologic progression and describe intensive care outcomes in Vietnamese children with HFMD. We performed a pooled patient-level analysis of pediatric HFMD datasets from Can Tho Children’s Hospital, Vietnam (2023–2025), comprising 488 hospital records. Variables were harmonized across datasets (fever, fever duration, startle response, blood glucose, white blood cell count, platelet count, C-reactive protein, and admission severity). Severe neurologic progression was defined as HFMD grade 2b or higher and/or autonomic dysfunction and/or need for intensive care. Intensive care unit (ICU) treatment and outcomes were summarized for severe cases managed in ICU (n=45). Across the pooled dataset, high fever (≥39°C), prolonged fever (more than 2 days), startle response, and hyperglycemia (blood glucose ≥160 mg/dL) were consistently associated with severe neurologic progression. In ICU patients, most presented with advanced severity (grade 3–4) requiring neurocritical supportive care, including intravenous immunoglobulin and cardio-respiratory support as indicated. Median ICU length of stay was 4 days (interquartile range 4–6), and all children recovered to discharge. In conclusion, readily observable emergency warning signs and early metabolic derangement can help flag risk of severe neurologic deterioration. Rapid triage and timely escalation to intensive care may contribute to favorable short-term outcomes.

Biography of the presenting author

Nguyen Nhat Duy is a medical doctor and researcher currently undergoing clinical training. He is affiliated with the University of Medicine and Pharmacy and completes clinical rotations in the Neurology Department at the Children’s Hospital in Can Tho, Vietnam. His research focuses on pediatric neurology, including early autism screening and the neurologic complications of infectious diseases such as Hand, Foot and Mouth Disease. He is an active contributor to pediatric clinical research and serves as the presenting author for this work.

Presenting author details

Full name: Nguyen Nhat Duy
Contact number: (+84)387117511

Email: nhatduyshlord136@gmail.com
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ORCID: 0009-0002-0641-1188

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Session name/ number: 4. Pathogenesis and infection
Category: Oral presentation