Research Article
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Year 2020, Volume: 10 Issue: 2, 248 - 252, 25.06.2020
https://doi.org/10.16899/jcm.756560

Abstract

References

  • Reference1: Romero JR. Aseptic and Viral Meningitis. In: Long SS, Ficher M, Prober CG, editors. Principles and practice of pediatric infectious diseases. 5th ed. Philadelphia, PA: Elsevier; 2018. p.292-7.
  • Reference2.: Ghabouli Shahroodi MJ, Ghazvini K, Sadeghi R, Sasan MS. Enteroviral Meningitisin Neonates and Children of Mashhad, Iran. Jundishapur J Microbiol. 2016 Mar7;9(5):e19955. doi: 10.5812/jjm.19955. eCollection 2016 May. PubMed PMID:27478556; PubMed Central PMCID: PMC4950267.
  • Reference3: Tan NW, Lee EY, Khoo GM, Tee NW, Krishnamoorthy S, Choong CT. Cerebrospinal fluid white cell count: discriminatory or otherwise for enteroviral meningitis in infants and young children? J Neurovirol. 2016 Apr;22(2):213-7. doi: 10.1007/s13365-015-0387-2. Epub 2015 Oct 13. PubMed PMID: 26463525.
  • Reference4: Shaker OG, Abdelhamid N. Detection of enteroviruses in pediatric patients with aseptic meningitis. Clin Neurol Neurosurg. 2015 Feb;129:67-71. doi: 10.1016/j.clineuro.2014.12.004. Epub 2014 Dec 19. PubMed PMID: 25553519.
  • Reference5: Kahraman H, Tünger A, Şenol Ş, Gazi H, Avcı M, Örmen B, Türker N, Atalay S, Köse Ş, Ulusoy S, Işıkgöz Taşbakan M, Sipahi OR, Yamazhan T, Gülay Z, Alp Çavuş S, Pullukçu H. [Investigation of bacterial and viral etiology in community acquired central nervous system infections with molecular methods]. Mikrobiyol Bul. 2017 Jul;51(3):277-285.
  • Reference6: Shukla B, Aguilera EA, Salazar L, Wootton SH, Kaewpoowat Q, Hasbun R. Aseptic meningitis in adults and children: Diagnostic and management challenges. J Clin Virol. 2017 Sep;94:110-114. doi: 10.1016/j.jcv.2017.07.016.
  • Reference7: Zakhour R, Aguilera E, Hasbun R, Wootton SH. Risk Classification for Enteroviral Infection in Children With Meningitis and Negative Gram Stain. Pediatr Emerg Care. 2018 Nov;34(11):791-796. doi: 10.1097/PEC.0000000000000912.
  • Reference8: Vareil M, Wille H, Kassab S, Le-Cornec C, Puges M, Desclaux A, Lafon ME,Tumiotto C, Cazanave C, Neau D. Clinical and biological features of enteroviral meningitis among adults and children and factors associated with severity and length of stay. J Clin Virol. 2018 Jul;104:56-60. doi: 10.1016/j.jcv.2018.04.017
  • Reference9: Paioni P, Barbey F, Relly C, Meyer Sauteur P, Berger C. Impact of rapid enterovirus polymerase chain reaction testing on management of febrile young infants < 90 days of age with aseptic meningitis. BMC Pediatr. 2020 Apr 16;20(1):166. doi: 10.1186/s12887-020-02066-0.
  • Reference10: Seiden JA, Zorc JJ, Hodinka RL, Shah SS. Lack of cerebrospinal fluid pleocytosis in young infants with enterovirus infections of the central nervous system. Pediatr Emerg Care. 2010 Feb;26(2):77-81. doi: 10.1097/PEC.0b013e3181ce2fad.
  • Reference11: Lee BE, Chawla R, Langley JM, Forgie SE, Al-Hosni M, Baerg K, Husain E, Strong J, Robinson JL, Allen U, Law BJ, Dobson S, Davies HD. Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of aseptic meningitis. BMC Infect Dis. 2006 Apr 10;6:68.
  • Reference12: Archimbaud C, Chambon M, Bailly JL, Petit I, Henquell C, Mirand A, Aublet-Cuvelier B, Ughetto S, Beytout J, Clavelou P, Labbé A, Philippe P, Schmidt J, Regagnon C, Traore O, Peigue-Lafeuille H. Impact of rapid enterovirus molecular diagnosis on the management of infants, children, and adults with aseptic meningitis. J Med Virol. 2009 Jan;81(1):42-8. doi: 10.1002/jmv.21330.

The Value of Cerebrospinal Fluid Polymerase Chain Reaction Test in the Diagnosis of Enteroviral Meningitis in Children

Year 2020, Volume: 10 Issue: 2, 248 - 252, 25.06.2020
https://doi.org/10.16899/jcm.756560

Abstract

Abstract:
Background: Non-polio enteroviruses (EVs) are emerged as the most common pathogens of aseptic meningitis in children. In this study we aimed to evaluate clinical, laboratory, cerebrospinal fluid (CSF) findings and the usefulness of CSF EV polymerase chain reaction on management of pediatric patients diagnosed as EV aseptic meningitis.
Material-methods:This study included the pediatric patients with aseptic meningitis between January 2014 and January 2016.
Results: A total of 23 patients (69.5% boys) diagnosed with EV aseptic meningitis with a median age of 57 months old (range; 1-168 months) were included. The most common months of the patients' admission to hospital were July and May. The most common clinical complaints were womiting (77.2%), fever (73.9%), headache (59%), neck stiffness (36.3%), seizure (22.7%) and altered consciousness (22.7%). CSF pleocytosis was observed in 16 (69.5%) patients and the median CSF white blood cell (WBC) count was 50 cells/mm3 ranged from 0 to 500 cells/mm3. It was found that, CSF cell count was significantly increased with age (p=0.02), whereas acute phase reactant levels and CSF biochemical components were statistically similar according to age (p>0.05). Median duration for hospitalization was 6 days (range: 1-28 days). Eight patients (34.7%) did not receive any antibiotics.
Conclusion: Absence of pleocytosis may be a diagnostic challange in very young infants with aseptic meningitis and CSF cell count significantly increases with age. By using rapid EV-PCR assays in the initial diagnosis of aseptic meningitis, the unnecessary usage of antibiotics in viral meningitis can be reduced and also the duration of hospitalization can be shortened.

References

  • Reference1: Romero JR. Aseptic and Viral Meningitis. In: Long SS, Ficher M, Prober CG, editors. Principles and practice of pediatric infectious diseases. 5th ed. Philadelphia, PA: Elsevier; 2018. p.292-7.
  • Reference2.: Ghabouli Shahroodi MJ, Ghazvini K, Sadeghi R, Sasan MS. Enteroviral Meningitisin Neonates and Children of Mashhad, Iran. Jundishapur J Microbiol. 2016 Mar7;9(5):e19955. doi: 10.5812/jjm.19955. eCollection 2016 May. PubMed PMID:27478556; PubMed Central PMCID: PMC4950267.
  • Reference3: Tan NW, Lee EY, Khoo GM, Tee NW, Krishnamoorthy S, Choong CT. Cerebrospinal fluid white cell count: discriminatory or otherwise for enteroviral meningitis in infants and young children? J Neurovirol. 2016 Apr;22(2):213-7. doi: 10.1007/s13365-015-0387-2. Epub 2015 Oct 13. PubMed PMID: 26463525.
  • Reference4: Shaker OG, Abdelhamid N. Detection of enteroviruses in pediatric patients with aseptic meningitis. Clin Neurol Neurosurg. 2015 Feb;129:67-71. doi: 10.1016/j.clineuro.2014.12.004. Epub 2014 Dec 19. PubMed PMID: 25553519.
  • Reference5: Kahraman H, Tünger A, Şenol Ş, Gazi H, Avcı M, Örmen B, Türker N, Atalay S, Köse Ş, Ulusoy S, Işıkgöz Taşbakan M, Sipahi OR, Yamazhan T, Gülay Z, Alp Çavuş S, Pullukçu H. [Investigation of bacterial and viral etiology in community acquired central nervous system infections with molecular methods]. Mikrobiyol Bul. 2017 Jul;51(3):277-285.
  • Reference6: Shukla B, Aguilera EA, Salazar L, Wootton SH, Kaewpoowat Q, Hasbun R. Aseptic meningitis in adults and children: Diagnostic and management challenges. J Clin Virol. 2017 Sep;94:110-114. doi: 10.1016/j.jcv.2017.07.016.
  • Reference7: Zakhour R, Aguilera E, Hasbun R, Wootton SH. Risk Classification for Enteroviral Infection in Children With Meningitis and Negative Gram Stain. Pediatr Emerg Care. 2018 Nov;34(11):791-796. doi: 10.1097/PEC.0000000000000912.
  • Reference8: Vareil M, Wille H, Kassab S, Le-Cornec C, Puges M, Desclaux A, Lafon ME,Tumiotto C, Cazanave C, Neau D. Clinical and biological features of enteroviral meningitis among adults and children and factors associated with severity and length of stay. J Clin Virol. 2018 Jul;104:56-60. doi: 10.1016/j.jcv.2018.04.017
  • Reference9: Paioni P, Barbey F, Relly C, Meyer Sauteur P, Berger C. Impact of rapid enterovirus polymerase chain reaction testing on management of febrile young infants < 90 days of age with aseptic meningitis. BMC Pediatr. 2020 Apr 16;20(1):166. doi: 10.1186/s12887-020-02066-0.
  • Reference10: Seiden JA, Zorc JJ, Hodinka RL, Shah SS. Lack of cerebrospinal fluid pleocytosis in young infants with enterovirus infections of the central nervous system. Pediatr Emerg Care. 2010 Feb;26(2):77-81. doi: 10.1097/PEC.0b013e3181ce2fad.
  • Reference11: Lee BE, Chawla R, Langley JM, Forgie SE, Al-Hosni M, Baerg K, Husain E, Strong J, Robinson JL, Allen U, Law BJ, Dobson S, Davies HD. Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of aseptic meningitis. BMC Infect Dis. 2006 Apr 10;6:68.
  • Reference12: Archimbaud C, Chambon M, Bailly JL, Petit I, Henquell C, Mirand A, Aublet-Cuvelier B, Ughetto S, Beytout J, Clavelou P, Labbé A, Philippe P, Schmidt J, Regagnon C, Traore O, Peigue-Lafeuille H. Impact of rapid enterovirus molecular diagnosis on the management of infants, children, and adults with aseptic meningitis. J Med Virol. 2009 Jan;81(1):42-8. doi: 10.1002/jmv.21330.
There are 12 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Ozge Metin 0000-0002-3465-6994

Ayşe Kaman 0000-0002-6188-6816

Celil Uysal This is me 0000-0001-8318-9352

Şükrü Güner 0000-0002-8860-6132

Publication Date June 25, 2020
Acceptance Date June 23, 2020
Published in Issue Year 2020 Volume: 10 Issue: 2

Cite

AMA Metin O, Kaman A, Uysal C, Güner Ş. The Value of Cerebrospinal Fluid Polymerase Chain Reaction Test in the Diagnosis of Enteroviral Meningitis in Children. J Contemp Med. June 2020;10(2):248-252. doi:10.16899/jcm.756560