Epidemiology of Aseptic Meningitis in Infants and Children (Shiraz - Iran)

Abstract

Background:: Viruses are by far the most common cause of meningitis in children. Objectives:: The aim of this study is to describe the epidemiology of viral/aseptic meningitis (AM) in children (2 months - 15 years) in Shiraz. Materials and Methods:: This is a cross-sectional prospective-descriptive study from May 2001 to May 2002 in Nemazi and Dastgheib Hospitals, Shiraz. EV meningitis was diagnosed using RT - PCR on Aseptic CSF samples. Mumps meningitis (MM) is defined (clinically) by simultaneous presence of parotitis and meningitis and negative PCR for EV. Clinical data were extracted from hospital archive files. Results:: During the study period, 688 CSF samples (from 598 patients) were analyzed. Among these samples, there were 218 (36.4%) cases of meningitis. Twenty seven (12.38%) were bacterial [Streptococcus pneumonia (11 cases), H. Influenzae (8 cases), Neisseria meningitidis (5 cases) and other organisms (3 cases)]. The rest of the cases (191 patients) were considered as AM. RT - PCR for detection of EV was carried out on 53.4% (102 out of 191) accessible aseptic CSF samples. Among these cases, only 12.7% (13 out of 102) were positive for EV. Twenty patients (19.6%) with negative (Enteroviral) PCR, had parotitis and were considered as MM. Other causes of AM were found in 8 (7.8%) cases (Brain Abscess and Guillain-Barre syndrome, each one in 2 cases, Partially treated bacterial meningitis, TB Meningitis, Leukemic meningitis and Varicella encephalitis each were detected in one case). Conclusions:: The cause of AM was found in 40.15 % (41 out of 102) of patients. Although at the time of this study (2001 - 2002) MM was the most common form of AM in children in Shiraz, Enteroviral Meningitis (EVM) was relatively close to it in prevalence (13 Enteroviral vs. 20 MM).