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Journal of Medical Virology Jan 2006Acute viral infections of the central nervous system (CNS) such as acute flaccid paralysis, meningitis, and encephalitis, are responsible for a high morbidity,...
Acute viral infections of the central nervous system (CNS) such as acute flaccid paralysis, meningitis, and encephalitis, are responsible for a high morbidity, particularly in children. Non-Polio enteroviruses (NPEV) are known to be responsible for over 80% of viral meningitis in which the etiologic agent is identified. In the present study, we show the frequency of enterovirus meningitis in Brazil from December 1998 to December 2003. Enterovirus were isolated from 162 (15.8%), of a total of 1,022 cerebrospinal fluid (CSF) specimens analyzed. Echovirus 30 was identified in 139 of these isolates (139/162-85.2%). Other identified enteroviruses were: Coxsackievirus B5 (3.7%), Echovirus 13 (3.7%), Echovirus 18 (3%), Echovirus 6 (1.2%), Echovirus 25 (1.2%), Echovirus 1 (0.6%), and Echovirus 4 (0.6%). Patients's age ranged from 28 days to 68 years old. The most frequent symptoms were fever (77%), headache (69.5%), vomiting (71.3%), neck stiffness (41.3%), convulsion (7.1%), and diarrhea (3.7%). Although, the majority of the patients recovered without any complication or permanent squeal, five deaths occurred. Throughout the surveillance period, five viral meningitis outbreaks were confirmed: four in the Southern Brazil and one in the Northeast Brazil. Echovirus 30 was responsible for four out of the five outbreaks while Echovirus 13 caused the fifth one. Besides the outbreaks, 734 sporadic cases were also identified during the study period and 59 of these were positive for virus isolation (8%). Echovirus 30 accounted for 70% of the isolates. Our results showed that Echovirus 30 was the most prevalent etiological agent of viral meningitis in Brazil, causing both outbreaks and sporadic cases.
Topics: Adolescent; Adult; Aged; Brazil; Cerebrospinal Fluid; Child; Child, Preschool; Enterovirus; Enterovirus Infections; Female; Humans; Infant; Infant, Newborn; Male; Meningitis, Viral; Middle Aged; Reverse Transcriptase Polymerase Chain Reaction
PubMed: 16299728
DOI: 10.1002/jmv.20509 -
Nihon Rinsho. Japanese Journal of... Mar 2006
Review
Topics: Acyclovir; Antiviral Agents; Herpes Simplex; Herpes Zoster; Herpesvirus 1, Human; Herpesvirus 2, Human; Humans; Meningitis, Aseptic; Meningitis, Viral; Polymerase Chain Reaction
PubMed: 16615482
DOI: No ID Found -
Epidemiological Bulletin Dec 2001
Topics: Disease Outbreaks; Humans; Infant; Meningitis, Viral
PubMed: 12058682
DOI: No ID Found -
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 -
The Pediatric Infectious Disease Journal Oct 2021Studies evaluating the epidemiology of pediatric meningitis are limited in our region. This study aimed to describe recent trends in the incidence of pediatric...
BACKGROUND
Studies evaluating the epidemiology of pediatric meningitis are limited in our region. This study aimed to describe recent trends in the incidence of pediatric meningitis.
METHODS
We estimated national trends in hospitalization rates for pediatric meningitis (<18 years) by analyzing data from the Health Insurance Review and Assessment database between 2010 and 2018. Meningitis cases were identified based on International Classification of Diseases, Tenth Revision (ICD-10) codes and hospitalization rates were calculated.
RESULTS
In this national population-based study, a total of 119,644 hospitalizations and 58 deaths due to pediatric meningitis were identified. The hospitalization rates of pediatric bacterial meningitis have declined by 50.0%, from 3.4 per 100,000 in 2010 to 1.7 per 100,000 in 2018. The mortality rates for bacterial and viral meningitis were 2.0% and 0.002%, respectively. Despite the decreased annual incidence of bacterial meningitis, its mortality rate did not change significantly during the study period. The only risk factor identified for mortality in bacterial meningitis patients among age group, sex, region of residence, and season was age below 1 year (P < 0.001). As children under 1 year have a high-mortality rate (4.2%), patients in this age group require close monitoring. The reasons behind indistinct seasonal patterns of bacterial meningitis warrant further investigation.
CONCLUSIONS
Childhood bacterial meningitis has shown a significant decline in incidence from 2010 to 2018. In contrast, viral meningitis has not shown a trend over time. Knowledge of these changes may aid clinicians in the decision-making process and management of meningitis patients.
Topics: Adolescent; Child; Child, Preschool; Databases, Factual; Female; Hospitalization; Humans; Incidence; Infant; International Classification of Diseases; Male; Meningitis, Bacterial; Meningitis, Viral; Population; Republic of Korea; Retrospective Studies; Risk Factors
PubMed: 33990524
DOI: 10.1097/INF.0000000000003190 -
Japanese Journal of Infectious Diseases Nov 2023Reverse-transcription polymerase chain reaction (RT-PCR)-confirmed enterovirus (EV) meningitis without pleocytosis has only been previously reported in children. In this... (Observational Study)
Observational Study
Reverse-transcription polymerase chain reaction (RT-PCR)-confirmed enterovirus (EV) meningitis without pleocytosis has only been previously reported in children. In this study, we examined the frequency of EV meningitis without pleocytosis in adults and compared its clinical features. We retrospectively analyzed the data of adult patients with EV meningitis confirmed using cerebrospinal fluid (CSF) RT-PCR. Among the 17 patients included in this study, 58.8% showed no pleocytosis. The median age and clinical symptoms did not differ between the pleocytosis and non-pleocytosis groups. There were no statistically significant differences in seasonal variation or time from the onset of meningitis symptoms to lumbar puncture. The peripheral white blood cell (WBC) count in patients with pleocytosis was significantly higher than that in patients without pleocytosis. The median CSF pressure showed a higher trend in the non-pleocytosis group. Patients with CSF pressures higher than normal were more common in the non-pleocytosis group. The median CSF protein values were higher than the normal values in both groups. We confirmed the high frequency of EV meningitis without pleocytosis in adults. Accurate diagnosis using RT-PCR is necessary when meningitis symptoms are prominent during an EV epidemic, and CSF protein levels and pressure are high, even if the CSF WBC count is normal.
Topics: Child; Humans; Adult; Infant; Leukocytosis; Retrospective Studies; Meningitis, Viral; Enterovirus Infections; Enterovirus
PubMed: 37394460
DOI: 10.7883/yoken.JJID.2023.123 -
Medical Principles and Practice :... 2020Several cerebrospinal fluid (CSF) biomarkers are used to distinguish between acute bacterial meningitis (BM) and viral meningitis (VM). We compared the ability of...
OBJECTIVE
Several cerebrospinal fluid (CSF) biomarkers are used to distinguish between acute bacterial meningitis (BM) and viral meningitis (VM). We compared the ability of lactate and glucose (GL) in CSF and the CSF/blood GL ratio to distinguish between acute BM and VM with typical and atypical CSF characteristics.
METHODS
Three hundred and twenty-four CSF reports were included, which were distributed as the acute BM, VM, and normal control groups (n = 63, 139, and 122, respectively).
RESULTS
Lactate level in the CSF of acute BM group was 4-fold higher than that in the acute VM and control groups (p < 0.0001). CSF lactate presented higher specificity (92%) and negative predictive value (94%) compared to CSF GL and CSF/blood GL ratio in distinguishing acute BM and VM. Definitive acute BM or VM with atypical CSF cell characteristics was observed in 23.2 and 21.6% of samples, respectively, and these groups showed reduced performance of characteristics of all CSF biomarkers. CSF lactate showed better operational characteristics than those of CSF GL and CSF/blood GL ratio, presenting the highest positive likelihood ratio, and thus aided in the differential diagnosis of VM with atypical CSF.
CONCLUSION
The CSF lactate assay can be routinely used in laboratories as a rapid, automated, and easy method that is independent of lactate blood levels.
Topics: Adolescent; Adult; Biomarkers; Blood Glucose; Child; Diagnosis, Differential; Female; Glucose; Humans; Lactic Acid; Male; Meningitis, Bacterial; Meningitis, Viral; Middle Aged; Sensitivity and Specificity; Young Adult
PubMed: 31480054
DOI: 10.1159/000501925 -
Ryoikibetsu Shokogun Shirizu 1999
Review
Topics: Diagnosis, Differential; Enterovirus; Enterovirus Infections; Humans; Meningitis, Viral; Prognosis; Serotyping
PubMed: 10201121
DOI: No ID Found -
Revista Medico-chirurgicala a... 2013Given its epidemic potential and development of severe forms of disease, viral meningitis (VM) is a serious public health problem.
UNLABELLED
Given its epidemic potential and development of severe forms of disease, viral meningitis (VM) is a serious public health problem.
AIM
to characterize the main clinical, epidemiologic features, the etiology and treatment of VM cases admitted to the Iasi Infectious Diseases Hospital, in 2012.
MATERIAL AND METHODS
We retrospectively analyzed the medical records of the patients admitted for viral meningitis at the Iasi "St. Parascheva" Infectious Diseases Hospital in the interval January 1- December 31, 2012 (98 cases). The etiologic diagnosis was made by determining the IgM/IgG antibodies against Coxsackie virus and/or West Nile virus in blood/CSF.
RESULTS
There was a fourfold increase in the number of cases as compared to the average for the years 2009-2011. Most cases (73.5%) were children aged 1 to 14 years. 61.8% of patients were males, 51.7% from urban areas. The most common symptom was headache (85.7%), followed by fever (77.6%), and vomiting (66.3%). Neck stiffness was absent in 28.6% cases. In43.5% of the 39 patients serologically investigated a Coxsackie virus infection was confirmed and 1/20 was positive for West Nile virus; three varicella-zoster virus infections and one mumps infection were diagnosed clinically. 68.3% of the patients received first-line antibiotic treatment.
CONCLUSIONS
The illness mainly affected children, fever and neck stiffness being sometimes absent. The etiology was known in 22.4% of cases; enter viruses being the most frequent causative agent. Most patients received antibiotic therapy. The course was favorable in all cases.
Topics: Adolescent; Adult; Child; Child, Preschool; Diagnosis, Differential; Enterovirus; Female; Fever; Headache; Hospitals, Isolation; Hospitals, University; Humans; Infant; Male; Meningitis, Viral; Patient Admission; Prevalence; Retrospective Studies; Risk Factors; Romania; Vomiting; West Nile virus
PubMed: 24340533
DOI: No ID Found -
Adolescent Medicine (Philadelphia, Pa.) Jun 2000Central nervous system infections in adolescents range from the diffuse cerebritis of encephalitis to the regional inflammation of meningitis, and very focal disease of... (Review)
Review
Central nervous system infections in adolescents range from the diffuse cerebritis of encephalitis to the regional inflammation of meningitis, and very focal disease of brain abscess. Clinical presentations reflect this wide spectrum, with encephalitis primarily characterized by altered mental status, meningitis by fever, headache, and neck stiffness, and brain abscess manifesting localizing findings. Encephalitis and viral meningitis are frequently caused by the seasonal enteroviruses and arboviruses, while most adolescent bacterial meningitis is due to Neisseria meningitidis and Streptococcus pneumoniae. The microbiology of brain abscess reflects underlying host risk factors. Gram-positive cocci are seen in patients with congenital heart disease, while respiratory flora including anaerobes are associated with sinus or otic disease. Lumbar puncture to characterize and culture the CSF remains the optimal test for the diagnosis and management of encephalitis and meningitis, while CT-guided needle biopsy may be both diagnostic and therapeutic for brain abscesses. New diagnostic tests include the use of PCR. A variety of safe and effective treatment regimens exists for most bacterial infections as well as for some herpesvirus infections. New vaccines are under study to further control bacterial meningitis.
Topics: Adolescent; Brain Abscess; Encephalitis; Humans; Meningitis, Bacterial; Meningitis, Viral
PubMed: 10916131
DOI: No ID Found