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Emerging Infectious Diseases Aug 2022During a mouse plague in early 2021, a farmer from New South Wales, Australia, sought treatment for aseptic meningitis and was subsequently diagnosed with locally...
During a mouse plague in early 2021, a farmer from New South Wales, Australia, sought treatment for aseptic meningitis and was subsequently diagnosed with locally acquired lymphocytic choriomeningitis virus infection. Whole-genome sequencing identified a divergent and geographically distinct lymphocytic choriomeningitis virus strain compared with other published sequences.
Topics: Animals; Australia; Lymphocytic Choriomeningitis; Lymphocytic choriomeningitis virus; Meningitis, Aseptic; Mice; New South Wales
PubMed: 35876533
DOI: 10.3201/eid2808.220119 -
Human Vaccines & Immunotherapeutics Jan 2021Mumps is a vaccine-preventable disease. Because the mumps vaccine can cause aseptic meningitis in rare cases, this vaccine is not routine in Japan. This has led to low... (Review)
Review
Mumps is a vaccine-preventable disease. Because the mumps vaccine can cause aseptic meningitis in rare cases, this vaccine is not routine in Japan. This has led to low vaccine coverage and severe disease burden in Japan. The present review summarizes mumps epidemiology and vaccination and discusses effective future strategies to mitigate the current disease burden of mumps in Japan. Although a recent study reported that mumps vaccine coverage rates are improving in Japan, current coverage rates are far below the optimal rate to suppress the ongoing epidemic, which has caused an average annual financial loss of 85 billion JPY between 2000 and 2016. Recent reports have demonstrated a much lower incidence of vaccine-induced aseptic meningitis in newly developed vaccines, especially when administered at 1 year of age. Cost-effectiveness studies suggest that routinization of the currently distributed domestic vaccine would be highly cost-effective. In addition, questionnaire surveillance data suggest that the majority of the Japanese population accepts the nominal risk of the vaccine when the proper information is provided. Finally, there are some successful programs in Japan that have attained high vaccine coverage rates with financial support from local governments. Taken together, these data suggest that the mumps vaccine should be immediately included in routine vaccines in Japan.
Topics: Humans; Infant; Japan; Measles-Mumps-Rubella Vaccine; Meningitis, Aseptic; Mumps; Mumps Vaccine; Vaccination
PubMed: 32530735
DOI: 10.1080/21645515.2020.1765619 -
Journal of Clinical Virology : the... Jun 2021Enteroviruses are amongst the most common causes of aseptic meningitis. Between November 2018 and May 2019, an outbreak of enterovirus-associated aseptic meningitis...
BACKGROUND
Enteroviruses are amongst the most common causes of aseptic meningitis. Between November 2018 and May 2019, an outbreak of enterovirus-associated aseptic meningitis cases was noted in the Western and Eastern Cape Provinces, South Africa.
OBJECTIVES
To describe the epidemiology and phylogeography of enterovirus infections during an aseptic meningitis outbreak in the Western and Eastern Cape Provinces of South Africa.
METHODS
Cerebrospinal fluid samples from suspected cases were screened using a polymerase chain reaction targeting the 5'UTR. Confirmed enterovirus-associated meningitis samples underwent molecular typing through species-specific VP1/VP2 primers and pan-species VP1 primers.
RESULTS
Between November 2018 and May 2019, 3497 suspected cases of aseptic meningitis were documented in the Western and Eastern Cape Provinces. Median age was 8 years (range 0-61), interquartile range (IQR=4-13 years), 405/735 (55%) male. 742/3497 (21%) cases were laboratory - confirmed enterovirus positive by routine diagnostic PCR targeting the 5'UTR. 128/742 (17%) underwent molecular typing by VP1 gene sequencing. Echovirus 4 (E4) was detected in 102/128 (80%) cases. Echovirus 9 was found in 7%, Coxsackievirus A13 in 3%. 10 genotypes contributed to the remaining 10% of cases. Synonymous mutations were found in most cases, with sporadic amino acid changes in 13 (12.7%) cases.
CONCLUSION
The aseptic meningitis outbreak was associated with echovirus 4. Stool samples are valuable for molecular typing in CSF confirmed EV-associated aseptic meningitis.
Topics: Adolescent; Adult; Child; Child, Preschool; Disease Outbreaks; Enterovirus; Enterovirus B, Human; Enterovirus Infections; Humans; Infant; Infant, Newborn; Male; Meningitis, Aseptic; Middle Aged; Phylogeny; RNA, Viral; South Africa; Young Adult
PubMed: 33962182
DOI: 10.1016/j.jcv.2021.104845 -
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 -
Virology Journal Jun 2021An outbreak of aseptic meningitis occurred from June to August 2016, in Inner Mongolia Autonomous Region, China.
BACKGROUND
An outbreak of aseptic meningitis occurred from June to August 2016, in Inner Mongolia Autonomous Region, China.
METHODS
To determine its epidemiological characteristics, etiologic agent, and possible origin, specimens were collected for virus isolation and identification, followed by molecular epidemiological analysis.
RESULTS
A total of 363 patients were clinically diagnosed from June 1st to August 31st 2016, and most cases (63.1%, n = 229) were identified between June 22nd and July 17th, with children aged 6 to 12 years constituting the highest percentage (68.9%, n = 250). All viral isolates from this study belonged to genotype C of echovirus 30 (E30), which dominated transmission in China. To date, two E30 transmission lineages have been identified in China, of which Lineage 2 was predominant. We observed fluctuant progress of E30 genetic diversity, with Lineage 2 contributing to increased genetic diversity after 2002, whereas Lineage 1 was significant for the genetic diversity of E30 before 2002.
CONCLUSIONS
We identified the epidemiological and etiological causes of an aseptic meningitis outbreak in Inner Mongolia in 2016, and found that Lineage 2 played an important role in recent outbreaks. Moreover, we found that Gansu province could play an important role in E30 spread and might be a possible origin site. Furthermore, Fujian, Shandong, Taiwan, and Zhejiang provinces also demonstrated significant involvement in E30 evolution and persistence over time in China.
Topics: Child; China; Disease Outbreaks; Echovirus Infections; Enterovirus B, Human; Humans; Meningitis, Aseptic; Phylogeny
PubMed: 34092258
DOI: 10.1186/s12985-021-01590-4 -
Cureus May 2021We report on a patient with Mollaret's meningitis to highlight the appropriate diagnostic criteria and benign prognosis without empiric antiviral therapy. An 83-year-old...
We report on a patient with Mollaret's meningitis to highlight the appropriate diagnostic criteria and benign prognosis without empiric antiviral therapy. An 83-year-old man with a history of aseptic meningitis of unknown etiology followed by full recovery presented with a two-day history of fevers, generalized weakness, and neurologic abnormalities. Cerebral spinal fluid (CSF) analysis demonstrated lymphocytic pleocytosis consistent with aseptic meningitis. Given his prior noninfectious aseptic meningitis and symptom-free interval, Mollaret's meningitis was suspected and empiric treatment for herpes simplex viruses (HSV) encephalitis with acyclovir was deferred. All CSF studies, including polymerase chain reactions for HSV-1 and HSV-2, returned negative with clinical improvement by the fourth day of admission. For patients suspected to have Mollaret's meningitis, lumbar puncture should be conducted promptly to facilitate diagnosis. Although several reports describe patients with CSF infection, the diagnosis of Mollaret's meningitis should be reserved for noninfectious cases. In such cases, empiric antiviral therapy for HSV encephalitis may be deferred and complete recovery is expected.
PubMed: 34189002
DOI: 10.7759/cureus.15264 -
Journal of Neuro-oncology May 2022Immune checkpoint inhibitors (ICIs) can induce adverse neurological effects. Due to its rarity as an adverse effect, meningitis has been poorly described. Therefore,... (Review)
Review
INTRODUCTION
Immune checkpoint inhibitors (ICIs) can induce adverse neurological effects. Due to its rarity as an adverse effect, meningitis has been poorly described. Therefore, meningitis diagnosis and management can be challenging for specialists. Moreover, meningitis can be an obstacle to resuming immunotherapy. Given the lack of alternatives, the possibility of reintroducing immunotherapy should be discussed on an individual basis. Here, we present a comprehensive systematic review of meningitis related to ICIs.
REVIEW
We performed a search for articles regarding immune-related meningitis published in PubMed up to November 2021 with the MeSH terms "meningitis" and "immune checkpoint" using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. We summarized the studies not only by category but also based on whether it was a primary article or case report to provide a systematic overview of the subject. We reviewed a total of 38 studies and herein report the clinical experiences, pharmacovigilance data and group knowledge from these studies.
CONCLUSION
This review summarizes the existing information on immune-related meningitis and the possibility of reintroducing immunotherapy after the development of central neurological side effects. To the best of our knowledge, there is little information in the literature to guide clinicians on decisions regarding whether immunotherapy should be continued after a neurological adverse event occurs, especially meningeal events. This review emphasizes the necessity of systematic examinations, steroid treatment (as a cornerstone of management) and the need for further exploratory studies to obtain a clearer understanding of how to better manage patients who experience these side effects. The findings summarized in this review can help provide guidance to practitioners who face this clinical situation.
Topics: Drug-Related Side Effects and Adverse Reactions; Humans; Immune Checkpoint Inhibitors; Immunotherapy; Meningitis; Meningitis, Aseptic
PubMed: 35416575
DOI: 10.1007/s11060-022-03997-7 -
The American Journal of Emergency... May 2022The AZD1222 is one of the vaccines used against coronavirus disease 2019 (COVID-19), which is currently being used in many countries worldwide. Some important...
The AZD1222 is one of the vaccines used against coronavirus disease 2019 (COVID-19), which is currently being used in many countries worldwide. Some important neurological side effects have been reported in association with this vaccine, but aseptic meningitis has not yet been reported. Herein, we report a case of aseptic meningitis in a 26-year-old health care worker, following the first dose of the AZD1222 vaccine.
Topics: Adult; COVID-19; COVID-19 Vaccines; ChAdOx1 nCoV-19; Humans; Meningitis, Aseptic; Vaccination
PubMed: 34955313
DOI: 10.1016/j.ajem.2021.12.035 -
Journal of Clinical Neuroscience :... Jun 2015We report a 67-year-old man with recurrent advanced oropharyngeal squamous cell carcinoma who developed aseptic meningitis, with first symptoms arising approximately... (Review)
Review
We report a 67-year-old man with recurrent advanced oropharyngeal squamous cell carcinoma who developed aseptic meningitis, with first symptoms arising approximately 9hours after the first administration of cetuximab, and review the literature to identify key signs and symptoms of this condition. Cetuximab is a monoclonal antibody targeting the epidermal growth factor receptor which has been rarely associated with aseptic meningitis. Besides the case description, a MEDLINE search was performed. In five patients identified in the literature and our patient, the leading signs and symptoms included headache, neck stiffness and high fever developing within a few hours of the first cetuximab administration. Cerebrospinal fluid (CSF) analysis revealed severe pleocytosis (range: 528-2300/μl) with dominance of neutrophils (⩾87%). Clinical recovery within 1-2weeks was accompanied by normalization of CSF cell count within 4-7days. Re-challenge with cetuximab at a reduced dose caused recurrent aseptic meningitis in one of three patients. In summary, aseptic meningitis is a rare complication after first cetuximab exposure that the clinician should be aware of. CSF analysis is the key to diagnosis and recovery is usually complete within days to weeks after withdrawal of the drug. Re-challenge may be considered but bears the risk of recurrence.
Topics: Aged; Antineoplastic Agents; Carcinoma, Squamous Cell; Cetuximab; Humans; Male; Meningitis, Aseptic; Oropharyngeal Neoplasms
PubMed: 25769257
DOI: 10.1016/j.jocn.2014.11.034 -
Neurologic Clinics Nov 1999Meningitis can be subdivided based on time course of onset and duration, cerebrospinal fluid (CSF) profile, and underlying origins into acute aseptic and septic... (Review)
Review
Meningitis can be subdivided based on time course of onset and duration, cerebrospinal fluid (CSF) profile, and underlying origins into acute aseptic and septic meningitis, recurrent meningitis, and chronic meningitis. These are distinct syndromes that require different management strategies. Most cases of meningitis are caused by infection. The causal agent is generally predictable based on the type of meningitis, host factors, and clues from the history and examination. CSF examination remains the critical diagnostic test.
Topics: Acute Disease; Brain; Chronic Disease; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Meningitis, Aseptic; Meningitis, Bacterial; Recurrence; Tomography, X-Ray Computed
PubMed: 10517924
DOI: 10.1016/s0733-8619(05)70162-6