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Journal of Paediatrics and Child Health Nov 2022Aseptic meningitis, including culture negative and viral meningitis, contributes a significant health-care burden, including unnecessary antibiotic use and...
AIM
Aseptic meningitis, including culture negative and viral meningitis, contributes a significant health-care burden, including unnecessary antibiotic use and hospitalisation to treat possible bacterial meningitis. This study analysed aseptic meningitis hospitalisations in New Zealand (NZ) children over 29 years.
METHODS
In this population-based study, aseptic meningitis hospitalisations in NZ children <15 years old were analysed from 1991 to 2020. Incident rate ratios were calculated using Poisson regression models. Variations in hospitalisations by age, year, sex, ethnicity, geographical region and socio-economic deprivation were analysed.
RESULTS
There were 5142 paediatric aseptic meningitis hospitalisations from 1991 to 2020. Most were unspecified viral meningitis (64%), followed by enterovirus (29%). Hospitalisation rates varied annually with a median of 18.4/100 000 children including a peak in 2001 of 56.4/100 000 (51.7-61.6). From 2002 to 2019, rates increased by 8.4%/year (7.2-9.5%) in infants <90 days old but decreased in all other age groups. In 2020, a reduction in hospitalisations to 9.6/100 000 (7.9-11.8) occurred, and in infants <90 days old were 0.37 times expected. Hospitalisations were 1.50 times (1.49-1.68) higher in males than females; higher in children of Māori (P < 0.001) and Pacific (P < 0.001) versus European ethnicity; and higher for children living in the most (2.44 times, (2.16-2.75)) versus least deprived households; and in northern versus southern NZ.
CONCLUSIONS
Aseptic meningitis hospitalisations increased in young infants during 29 years of surveillance, apart from 2020 when admissions reduced during the COVID-19 pandemic. In contrast, hospitalisations decreased in children aged >1 year. Further investigation into reasons for higher admissions by ethnic group, geographical location and increased deprivation are required.
Topics: Infant; Male; Female; Child; Humans; Adolescent; Meningitis, Aseptic; New Zealand; Pandemics; COVID-19; Hospitalization; Meningitis, Viral
PubMed: 35861029
DOI: 10.1111/jpc.16131 -
Kinderkrankenschwester : Organ Der... Jan 2017
Topics: Adolescent; Adult; Age Factors; Child; Child Day Care Centers; Child, Preschool; Encephalitis, Viral; Germany; Humans; Infant; Infant, Newborn; Measles; Measles Vaccine; Meningitis, Viral; Vaccination Refusal; Young Adult
PubMed: 30388331
DOI: No ID Found -
The Lancet. Infectious Diseases Feb 2019Human parechovirus infections are the second most common cause of viral meningitis in children. These infections are most frequently seen in infants younger than 90... (Review)
Review
Human parechovirus infections are the second most common cause of viral meningitis in children. These infections are most frequently seen in infants younger than 90 days. Clinical manifestations include encephalitis, meningitis, myocarditis, and sepsis, which can lead to serious neurodevelopmental sequelae in young infants. Molecular techniques, including PCR assays, are the preferred diagnostic methods and have contributed to an increase in reported cases, along with an increasing awareness of the causal role of human parechovirus in infant diseases. However, focused clinical and diagnostic investigations of human parechovirus in infants and the use of their results in management is varied, partly because of the scarcity of robust incidence data and spectrum of clinical presentations of the infection. In this Review, we outline clinical cohort and epidemiological studies that can be used to inform the evidence-based management of young infants with human parechovirus disease and identify key research priorities. An improved understanding of the pathogenesis and epidemiology of these infections is required to inform an evidence-based approach to diagnosis and treatment in the future.
Topics: Adolescent; Adult; Antiviral Agents; Child; Child, Preschool; Enterovirus; Enterovirus Infections; Female; Humans; Incidence; Infant; Infant, Newborn; Male; Meningitis, Viral; Mutation Rate; Parechovirus; Reverse Transcriptase Polymerase Chain Reaction
PubMed: 30322791
DOI: 10.1016/S1473-3099(18)30288-3 -
Heliyon May 2024Acute meningitis is a disease with case fatality and disability rate that is dependent on the causative agent.
BACKGROUND
Acute meningitis is a disease with case fatality and disability rate that is dependent on the causative agent.
OBJECTIVE
Determine the meningitis trend in Iraq from 2007 to 2023 using a joinpoint regression at national and sub-national levels and describe the epidemiology.
METHODS
Joinpoint regression model was used on surveillance data from Jan 2007 until May 2023, to calculate annual and average annual percent changes to determine the trend. Meningitis total count was modelled by year of reporting and province using the log transformation and Poisson variance. Best-fit model was chosen based on the weighted BIC criteria as the final point.
RESULTS
Bacterial meningitis was higher than viral meningitis from 2007 to 2018, then viral meningitis started to exceed till 2023. Meningococcal meningitis was lower than other bacterial and viral meningitis from 2007 to 2023. Most meningitis cases across the years were lower than 15 years, at almost 80 %, while 20 %-40 % were lower than one year. Across all years, 55 % of the cases were males; apart from 2019, 70 % were females.
CONCLUSION
In Iraq, viral meningitis has been the predominant type since 2018. Most meningitis patients were lower than 15-year-old males. The meningitis trend in Iraq was stable from 2007 till 2023.
PubMed: 38707473
DOI: 10.1016/j.heliyon.2024.e30088 -
Expert Review of Medical Devices Mar 2023Mechanical methods aimed at the filtration of the cerebrospinal fluid (CSF) are a group of therapies that have been proposed to treat neurological conditions where... (Review)
Review
INTRODUCTION
Mechanical methods aimed at the filtration of the cerebrospinal fluid (CSF) are a group of therapies that have been proposed to treat neurological conditions where pathogens are present in the CSF. Even though the industry of medical devices has not been very active in this field, there is a lack of systematization of the different systems and procedures that can be applied.
AREAS COVERED
First, we systematize the classification and definitions of procedures and systems for mechanical filtration of the CSF. Then, we made a literature review in search of clinical or preclinical studies where any system of mechanical CSF clearance was proposed or applied.
EXPERT OPINION
We found mechanical filtration of the CSF has been explored in subarachnoid hemorrhage, CNS infections (bacterial, viral, and fungal), meningeal carcinomatosis, multiple sclerosis, autoimmune encephalitis, and polyradiculomyelitis. Brain aging and neurodegenerative diseases are additional potential conditions of interest. While there is some preliminary positive evidence for many of these conditions, more advanced systems, detailed descriptions of procedures, and rigorous validations are needed to make these therapies a reality in the next decades.
Topics: Humans; Encephalitis; Nervous System Diseases; Multiple Sclerosis; Aging; Hashimoto Disease
PubMed: 36799735
DOI: 10.1080/17434440.2023.2181695 -
Biomedical Papers of the Medical... Dec 2019Enteroviruses (EVs) are the most common agents of aseptic meningitis. Some serotypes can cause serious neuroinfection leading to death. The aim of this study was to...
AIMS
Enteroviruses (EVs) are the most common agents of aseptic meningitis. Some serotypes can cause serious neuroinfection leading to death. The aim of this study was to determine the representation of EVs in the etiology of aseptic meningitis in children and to analyze the demographic, clinical, laboratory, and epidemiological characteristics of patients with EV meningitis.
PATIENTS AND METHODS
This was a prospective study including 147 patients in three groups: EV meningitis, tick-borne encephalitis, and aseptic meningitis with unidentified agent.
RESULTS
Boys with EV meningitis predominated over girls. The average patient age was 11 years. Compared to the control group, these patients suffered more from stiff back (P=0.010), vomiting and nausea (P=0.009). They had shorter symptom duration (P<0.001), higher C-reactive protein in blood (P<0.001), higher predominance of polynuclears (P=0.026), and greater lactate (P=0.003) in cerebrospinal fluid (CSF). The serotype seen most frequently (68%) was ECHO virus (ECV) 30.
CONCLUSIONS
Enteroviruses play the most important role in the differential diagnosis of aseptic meningitis. Short symptom duration, slightly higher inflammatory parameters in blood, predominance of polynuclears, and elevated CSF lactate have predictive value in diagnosing this disease. ECV 30 (frequently the agent of epidemics in the Czech Republic) was the aseptic meningitis agent most often seen.
Topics: Adolescent; Child; Child, Preschool; Czech Republic; Enterovirus; Enterovirus Infections; Female; Humans; Male; Meningitis, Aseptic; Meningitis, Viral; Prospective Studies; Reverse Transcriptase Polymerase Chain Reaction; Sequence Analysis
PubMed: 30631207
DOI: 10.5507/bp.2018.082 -
Archives of Disease in Childhood.... Apr 2017Enterovirus (EV) is the most common cause of aseptic meningitis and has a benign course, unlike EV encephalitis, which can result in long-term neurological sequelae.... (Review)
Review
Enterovirus (EV) is the most common cause of aseptic meningitis and has a benign course, unlike EV encephalitis, which can result in long-term neurological sequelae. There are no active treatments or prophylactic agents, and management is purely supportive. Obtaining an EV-positive cerebrospinal fluid result usually allows antimicrobial treatment to be stopped. This review will answer some of the common questions surrounding EV meningitis/encephalitis.
Topics: Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Drug Administration Schedule; Enterovirus Infections; Female; Humans; Infant; Infant, Newborn; Male; Meningitis, Viral
PubMed: 27789515
DOI: 10.1136/archdischild-2016-310632 -
Pediatric Neurology Mar 2019Over the past two decades, West Nile virus has become the most common arbovirus in North America, leading to several outbreaks and infecting thousands of people.... (Review)
Review
Over the past two decades, West Nile virus has become the most common arbovirus in North America, leading to several outbreaks and infecting thousands of people. Mosquitos help transmit the virus in the majority of cases, but transmission occurs via blood transfusions, organ transplantation, and possibly pregnancy and breastfeeding. While most infected patients experience mild to no symptoms, thousands of West Nile virus-associated neuroinvasive cases have been reported in the United States, with over 700 cases occurring in children from 2003 to 2016. Neuroinvasive disease presents as meningitis, encephalitis, or acute flaccid paralysis, and carries a high likelihood of poor outcome, including severe neurological disability or death. To date, no pharmacologic treatment has proven effective. Therapeutic clinical trials have not been successfully completed due to the sporadic nature of viral outbreaks and resultant poor study enrollment. Although older age and chronic disease are risk factors for neuroinvasive West Nile virus disease in adults, the specific factors that influence the risk in pediatric populations have not been fully elucidated. This review summarizes the most recent literature regarding West Nile virus-associated neuroinvasive disease, especially as it pertains to the pediatric population. Moreover, the review describes the epidemiology, clinical, laboratory, and radiographic findings, and outlines the various therapies that have been trialed and potential future research directions.
Topics: Central Nervous System Viral Diseases; Child; Humans; Meningitis, Viral; Myelitis; Neuromuscular Diseases; West Nile Fever; West Nile virus
PubMed: 30611518
DOI: 10.1016/j.pediatrneurol.2018.07.019 -
Journal of Neurovirology Jun 2020Human enteroviruses (EV) are the most common cause of viral meningitis in children. Human parechoviruses (HPeV) are increasingly being recognized as a cause of central...
Human enteroviruses (EV) are the most common cause of viral meningitis in children. Human parechoviruses (HPeV) are increasingly being recognized as a cause of central nervous system (CNS) infections and sepsis-like disease in children. Both viruses belong to Picornaviridae family. The clinical picture in EV and HPeV infections is usually nonspecific. Therefore, molecular detection of both viruses is needed for etiological diagnosis. In this case report, we describe and discuss clinical and laboratory findings of two consecutive episodes of viral meningitis caused by EV and HPeV, respectively, occurring in the first month of a newborn's life.
Topics: Enterovirus B, Human; Female; Humans; Infant, Newborn; Meningitis, Viral; Parechovirus; Picornaviridae Infections; RNA, Viral; Recurrence; Reverse Transcriptase Polymerase Chain Reaction; Sepsis; Sequence Analysis, DNA
PubMed: 32026339
DOI: 10.1007/s13365-020-00829-0 -
Acta Neurologica Taiwanica Mar 2022Meningitis is one of the most dangerous infection affecting children. The need for rapid and accurate diagnosis is mandatory for improving the outcome.
Accuracy of Cerebrospinal Fluid C-Reactive Protein and Multiplex Polymerase Chain Reaction and Serum Procalcitonin in Diagnosis of Bacterial and Viral Meningitis in Children.
BACKGROUND
Meningitis is one of the most dangerous infection affecting children. The need for rapid and accurate diagnosis is mandatory for improving the outcome.
AIM OF THE WORK
to evaluate the role of multiplex polymerase chain reaction (PCR), cerebrospinal fluid (CSF)-C-reactive protein (CRP) and serum procalcitonin (PCT) in diagnosis of meningitis and to detect its accuracy.
PATIENTS AND METHODS
A cross-sectional study was carried out in University Children hospital, Faculty of Medicine, between November 2019 and September 2020. The study was approved by the Ethics Review Board of Faculty of Medicine, Assiut University, and informed written consent was obtained. The committee's reference number is 17200161.
CLINICALTRIALS
gov ID: NCT03387969. 48 Children aged 2 to 18 years with meningitis were included. Detailed history and examination. Blood glucose level at time of admission prior to lumbar puncture, serum CRP level, serum PCT, CSF-CRP level and Multiplex PCR were evaluated.
FUNDING
The study was supported by Grant Office of Faculty of Medicine, Assiut University with grant NO. 2018-01-04-006-R2.
RESULTS
The mean age of children was 3.27 plus or minus 1.27 years. 35 (72.9%) cases were bacterial meningitis, while 13 (27.1%) cases were viral meningitis. Patients with bacterial meningitis had significantly higher serum CRP, serum PCT and higher CSF-CRP and significantly lower CSF/blood glucose compared to viral meningitis. Multiplex PCR had 94% sensitivity and 100% specificity for diagnosis of bacterial and viral meningitis.
CONCLUSION
CSF-CRP, CSF/blood glucose, PCT and Multiplex-PCR may help in diagnosis and differentiation of bacterial and viral meningitis.
Topics: Adolescent; C-Reactive Protein; Calcitonin; Child; Child, Preschool; Cross-Sectional Studies; Humans; Infant; Meningitis, Bacterial; Meningitis, Viral; Multiplex Polymerase Chain Reaction; Procalcitonin
PubMed: 35266132
DOI: No ID Found