Enterovirus D68 Clinical Presentation

Updated: Jan 11, 2016
  • Author: Jean Gabriel Bustamante Alvarez, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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The spectrum of clinical presentation of enterovirus D68 (EV-D68) infection can range from mild respiratory infection to severe disease, warranting intensive care unit admission, bi-level positive airway ventilation, or even intubation. Some cases have resulted in death. [11, 2]

Potential manifestations of EV-D68 infection are as follows:

  • Acute onset
  • Cough
  • Fever (although a considerable percentage of cases without fever reported in the latest outbreaks)
  • Rhinorrhea
  • Sore throat
  • Fatigue
  • Headache
  • Myalgia
  • Dyspnea
  • Diarrhea
  • Bronchiolitis [1]


Physical examination may reveal the following:

  • Wheezing
  • Rhinorrhea
  • Fever
  • Hypoxemia [1]

Cases involving acute neurological illness may have the following characteristics: [13, 15]

  • Preceding febrile illness with upper respiratory tract symptoms or GI prodrome occurring 3-16 days before onset of neurological illness
  • Limb paresis or flaccid paralysis
  • Ptosis, facial droop, dysarthria, dysphagia, diplopia
  • Absence of sensory deficits
  • Meningismus in cases of meningoencephalitis (one case described in 2008 in New Hampshire [9] )