Abstract
BackgroundNon-polio human enteroviruses are the leading cause of aseptic meningitis in children. The role of enterovirus PCR for diagnosis and management of aseptic meningitis has not been fully explored.Methodology/Principal FindingsA retrospective study was conducted to determine the epidemiological, clinical, and laboratory characteristics of aseptic meningitis and to evaluate the role of enterovirus PCR for the diagnosis and management of this clinical entity. The medical records of children who had as discharge diagnosis aseptic or viral meningitis were reviewed. A total of 506 children, median age 5 years, were identified. The annual incidence rate was estimated to be 17/100,000 children less than 14 years of age. Most of the cases occurred during summer (38%) and autumn (24%). The dominant clinical symptoms were fever (98%), headache (94%) and vomiting (67%). Neck stiffness was noted in 60%, and irritation in 46% of the patients. The median number of CSF cell count was 201/mm3 with polymorphonuclear predominance (>50%) in 58.3% of the cases. Enterovirus RNA was detected in CSF in 47 of 96 (48.9%) children tested. Children with positive enterovirus PCR had shorter hospitalization stay as compared to children who had negative PCR or to children who were not tested (P = 0.01). There were no serious complications or deaths.ConclusionsEnteroviruses accounted for approximately one half of cases of aseptic meningitis. PCR may reduce the length of hospitalization and plays important role in the diagnosis and management of children with aseptic meningitis.
Highlights
Aseptic meningitis refers to a clinical syndrome of meningeal inflammation in which common bacterial agents cannot be identified in the cerebrospinal fluid (CSF) [1]
In this report we present the epidemiological, clinical, and laboratory characteristics of aseptic meningitis in our geographic region, and the role of Amplicor Eneterovirus polymerase chain reaction (PCR) in the diagnosis and management of this disease
It was shown that the use of enterovirus PCR in children with aseptic meningitis may shorten the hospital stay and decrease the use of antimicrobial agents
Summary
Aseptic meningitis refers to a clinical syndrome of meningeal inflammation in which common bacterial agents cannot be identified in the CSF [1]. Non-polio human enteroviruses (NPHEV) are the leading recognizable cause of aseptic meningitis accounting for 80% to 92% of all cases in which a pathogen is identified [1,2,3]. In the USA alone NPHEV is estimated to cause 10 to 15 million symptomatic infections annually and at least 75,000 cases of aseptic meningitis [3]. Non-polio human enteroviruses are the leading cause of aseptic meningitis in children. The role of enterovirus PCR for diagnosis and management of aseptic meningitis has not been fully explored. A retrospective study was conducted to determine the epidemiological, clinical, and laboratory characteristics of aseptic meningitis and to evaluate the role of enterovirus PCR for the diagnosis and management of this clinical entity. PCR may reduce the length of hospitalization and plays important role in the diagnosis and management of children with aseptic meningitis
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