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Emerging Infectious Diseases Jan 2017To determine the causes of viral meningitis, we analyzed 22 cerebrospinal fluid samples collected during the 2014-2015 dengue epidemics in Brazil. We identified 3...
To determine the causes of viral meningitis, we analyzed 22 cerebrospinal fluid samples collected during the 2014-2015 dengue epidemics in Brazil. We identified 3 serotypes of dengue virus (DENV-1, -2, and -3), as well as co-infection with 2 or 3 serotypes. We also detected the Asian II genotype of DENV-2.
Topics: Brazil; Child; Child, Preschool; Coinfection; Dengue; Dengue Virus; Female; Genotype; Humans; Infant; Male; Meningitis, Viral; Phylogeny; RNA, Viral; Serogroup
PubMed: 27983492
DOI: 10.3201/eid2301.160817 -
Medicine Aug 2017Differential Diagnosis of bacterial and viral meningitis remains an important clinical problem. A number of methods to assist in the diagnoses of meningitis have been... (Observational Study)
Observational Study
Differential Diagnosis of bacterial and viral meningitis remains an important clinical problem. A number of methods to assist in the diagnoses of meningitis have been developed, but none of them have been found to have high specificity with 100% sensitivity.We conducted a retrospective analysis of the medical records of 148 children hospitalized in St. Joseph Children's Hospital in Poznań. In this study, we applied for the first time the original methodology of dominance-based rough set approach (DRSA) to diagnostic patterns of meningitis data and represented them by decision rules useful in discriminating between bacterial and viral meningitis. The induction algorithm is called VC-DomLEM; it has been implemented as software package called jMAF (http://www.cs.put.poznan.pl/jblaszczynski/Site/jRS.html), based on java Rough Set (jRS) library.In the studied group, there were 148 patients (78 boys and 70 girls), and the mean age was 85 months. We analyzed 14 attributes, of which only 4 were used to generate the 6 rules, with C-reactive protein (CRP) being the most valuable.Factors associated with bacterial meningitis were: CRP level ≥86 mg/L, number of leukocytes in cerebrospinal fluid (CSF) ≥4481 μL, symptoms duration no longer than 2 days, or age less than 1 month. Factors associated with viral meningitis were CRP level not higher than 19 mg/L, or CRP level not higher than 84 mg/L in a patient older than 11 months with no more than 1100 μL leukocytes in CSF.We established the minimum set of attributes significant for classification of patients with meningitis. This is new set of rules, which, although intuitively anticipated by some clinicians, has not been formally demonstrated until now.
Topics: Algorithms; C-Reactive Protein; Child; Child, Preschool; Diagnosis, Computer-Assisted; Diagnosis, Differential; Female; Humans; Infant; Leukocyte Count; Male; Meningitis, Bacterial; Meningitis, Viral; Retrospective Studies
PubMed: 28796045
DOI: 10.1097/MD.0000000000007635 -
Saudi Medical Journal Mar 2019To assess meningitis treatment in Lebanon's compatibility with the Infectious Diseases Society of America (IDSA) guidelines and the effect of non-compliance on...
To assess meningitis treatment in Lebanon's compatibility with the Infectious Diseases Society of America (IDSA) guidelines and the effect of non-compliance on mortality. Methods: This is a retrospective study, conducted in 5 Lebanese hospitals, and enrolling all patients diagnosed with meningitis who presented to the involved hospitals from January 2008 to December 2016. Results: A total of 252 participants were enrolled in the study. Of these patients, 205 (82.7%) were diagnosed with viral meningitis and 47 (17.3%) with bacterial meningitis, which was confirmed using laboratory tests. For patients with viral meningitis, 128 (62.4%) remained on the initial prescribed antibiotics despite the negative cerebrospinal fluid (CSF) and blood culture results. For bacterial meningitis patients, 30.8% received treatment regimen incompatible with the IDSA guidelines. The most common reason for the treatment incompatibility was the definitive drug choice after the culture results (49.1%) and the least common reason was inappropriate hospital stay days (25.9%). The mortality rate was 13.5%. Having low proteins values in the CSF (odds ratio=0.095) was associated with lower mortality compared to patients with normal protein values. Conclusion: This study shows a high percentage of inappropriate treatment in Lebanese hospitals despite these hospitals having adopted international treatment guidelines. This inappropriate management was associated with an increasing rate of mortality and neurological complications.
Topics: Adolescent; Adult; Anti-Bacterial Agents; Antiviral Agents; Cerebrospinal Fluid Proteins; Child; Child, Preschool; Female; Guideline Adherence; Hospitals; Humans; Infant; Infant, Newborn; Lebanon; Male; Medication Errors; Meningitis, Bacterial; Meningitis, Viral; Middle Aged; Practice Guidelines as Topic; Retrospective Studies; Young Adult
PubMed: 30834421
DOI: 10.15537/smj.2019.3.23965 -
Minerva Pediatrica Apr 2019Enterovirus (EV) and Parechovirus (HPeV) are a frequent cause of infection in children. This review gives an overview of possible causes for differences in clinical... (Review)
Review
Enterovirus and parechovirus infections in children: differences in clinical presentation, mechanisms for meningitis without pleocytosis and mechanisms involved in the neurological outcome.
Enterovirus (EV) and Parechovirus (HPeV) are a frequent cause of infection in children. This review gives an overview of possible causes for differences in clinical presentation. EV and HPeV can cause a meningitis with or without pleocytosis. Different possible mechanisms for meningitis without pleocytosis are given. Little is known about the prognosis and long-term effects of EV and HPeV meningitis in children. Only some studies with a small number of children with EV or HPeV meningitis are reported. The different possible mechanisms involved in the neurological outcome after EV or HPeV meningitis will be discussed.
Topics: Child; Enterovirus Infections; Humans; Leukocytosis; Meningitis, Viral; Picornaviridae Infections; Prognosis
PubMed: 30511561
DOI: 10.23736/S0026-4946.18.05449-X -
BMJ (Clinical Research Ed.) Jan 2008
Topics: Diagnosis, Differential; Humans; Meningitis, Viral
PubMed: 18202044
DOI: 10.1136/bmj.39458.446551.3A -
The American Journal of Case Reports Sep 2015Neurologic complications can occur with varicella zoster virus (VZV) infection, usually after vesicular exanthem. A review of the literature revealed 3 cases of viral... (Review)
Review
BACKGROUND
Neurologic complications can occur with varicella zoster virus (VZV) infection, usually after vesicular exanthem. A review of the literature revealed 3 cases of viral meningitis associated with 6th nerve palsy but without significantly increased intracranial pressure.
CASE REPORT
We report a case of a previously healthy 15-year-old girl with aseptic meningitis as a result of reactivated-VZV infection with symptoms of increased intracranial pressure and reversible 6th cranial nerve palsy but without exanthema. Diagnosis was made by detection of VZV-DNA in cerebrospinal fluid using polymerase chain reaction and documented high intracranial pressure. Full recovery was achieved after a course of acyclovir and acetazolamide.
CONCLUSIONS
This case demonstrates that VZV may be considered in cases of aseptic meningitis in immunocompetent individuals, even without exanthema, and it may increase the intracranial pressure, leading to symptoms, and causing reversible neurological deficit.
Topics: Adolescent; Antiviral Agents; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Meningitis, Aseptic; Meningitis, Viral
PubMed: 26342350
DOI: 10.12659/AJCR.894045 -
Scottish Medical Journal Jul 1969
Topics: Adolescent; Adult; Age Factors; Child; Child, Preschool; Female; Humans; Male; Meningitis, Viral; Mumps virus; Retrospective Studies; Scotland; Sex Factors; Time Factors
PubMed: 5807601
DOI: 10.1177/003693306901400704 -
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 -
Clinical Infectious Diseases : An... Dec 1993We report the cases of two infants with meningitis due to parainfluenza virus type 3. This is the first time that documented clinical and laboratory details have been... (Review)
Review
We report the cases of two infants with meningitis due to parainfluenza virus type 3. This is the first time that documented clinical and laboratory details have been reported for a 1-month-old infant with meningitis due to parainfluenza virus type 3 (our second case). We reviewed the literature and determined that CNS involvement by parainfluenza virus type 3 appears rare. Clinicians should be aware that parainfluenza virus type 3, one of the most common causes of viral respiratory infection in infancy, can also produce infection of the CNS and that hemadsorption testing of CSF specimens submitted for viral culture is necessary for detecting these paramyxoviruses.
Topics: Cerebrospinal Fluid; Hemadsorption; Humans; Infant; Male; Meningitis, Viral; Parainfluenza Virus 3, Human; Paramyxoviridae Infections
PubMed: 8110958
DOI: 10.1093/clinids/17.6.995 -
Clinical Medicine & Research Dec 2009Three patients with viral infections of the central nervous system (CNS) were evaluated on an inpatient infectious diseases consultation service within a two-week... (Review)
Review
Three patients with viral infections of the central nervous system (CNS) were evaluated on an inpatient infectious diseases consultation service within a two-week period. These cases, caused by herpes simplex virus, varicella zoster virus and enterovirus, highlight the importance of viral pathogens in causing debilitating infections of the CNS and provide examples of the utility of molecular diagnostics in evaluating patients with encephalitis and meningitis. The importance of antiviral therapy is particularly underscored by these cases, as is the variability in response of patients to such agents.
Topics: Aged; Aged, 80 and over; Encephalitis, Viral; Enterovirus; Female; Herpesvirus 3, Human; Humans; Male; Meningitis, Viral; Middle Aged; Simplexvirus
PubMed: 19889944
DOI: 10.3121/cmr.2009.864