Enteroviral Meningitis in Infants
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Purpose: Enteroviruses (EV) have been known as one of the important pathogens of aseptic meningitis in pediatrics. Clinical manifestations include asymptomatic cases to serious neurologic sequlaes. This study aimed to describe an overview of the seasonality, laboratory, and clinical characteristics of enteroviral meningitis in pediatric patients over a 7-year period. Methods: We performed a retrospective medical record review of patients with a positive cerebrospinal fluid (CSF) enterovirus polymerase chain reaction (PCR) result in the pediatric department of Chung-Ang University Hospital between January 2008 and December 2014. Patients were subsequently divided into ≤1-year age group and >1 year age group. Results: Of 302 patients with aseptic meningitis, 121 were diagnosed with enteroviral meningitis. There were 25 patients in the ≤1-year age group. Patients were detected throughout all four seasons but were more prevalent in the summer months, especially July. Patients in the ≤1-year age group had more seizures (P=0.034) and rashes (P=0.001), but fewer gastrointestinal symptoms (P=0.001) than patients in the >1-year age group.No significant difference was found between the two groups in terms of total white blood cell count and CSF analysis. Conclusion: There is prominent summer seasonality for enteroviral meningitis detections. Seizures were more common in the ≤1-year age group. The combination of information from epidemiologic, clinical, and laboratory findings are necessary to facilitate the diagnosis of enteroviral meningitis. Infants often do not exhibit the common signs of enteroviral meningitis, and are at an increased risk for seizure; therefore, physicians should pay particular attention to this population.
Abstract
Purpose: Enteroviruses (EV) have been known as one of the important pathogens of aseptic meningitis in pediatrics. Clinical manifestations include asymptomatic cases to serious neurologic sequlaes. This study aimed to describe an overview of the seasonality, laboratory, and clinical characteristics of enteroviral meningitis in pediatric patients over a 7-year period. Methods: We performed a retrospective medical record review of patients with a positive cerebrospinal fluid (CSF) enterovirus polymerase chain reaction (PCR) result in the pediatric department of Chung-Ang University Hospital between January 2008 and December 2014. Patients were subsequently divided into ≤1-year age group and >1 year age group. Results: Of 302 patients with aseptic meningitis, 121 were diagnosed with enteroviral meningitis. There were 25 patients in the ≤1-year age group. Patients were detected throughout all four seasons but were more prevalent in the summer months, especially July. Patients in the ≤1-year age group had more seizures (P=0.034) and rashes (P=0.001), but fewer gastrointestinal symptoms (P=0.001) than patients in the >1-year age group.No significant difference was found between the two groups in terms of total white blood cell count and CSF analysis. Conclusion: There is prominent summer seasonality for enteroviral meningitis detections. Seizures were more common in the ≤1-year age group. The combination of information from epidemiologic, clinical, and laboratory findings are necessary to facilitate the diagnosis of enteroviral meningitis. Infants often do not exhibit the common signs of enteroviral meningitis, and are at an increased risk for seizure; therefore, physicians should pay particular attention to this population.
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