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A season of aseptic meningitis in Germany: epidemiologic, clinical and diagnostic aspects

 

作者: ANTJE BÖTTNER,   SAID DANESCHNEJAD,   WERNER HANDRICK,   VOLKER SCHUSTER,   UWE LIEBERT,   WIELAND KIESS,  

 

期刊: The Pediatric Infectious Disease Journal  (OVID Available online 2002)
卷期: Volume 21, issue 12  

页码: 1126-1132

 

ISSN:0891-3668

 

年代: 2002

 

出版商: OVID

 

关键词: Aseptic meningitis;enterovirus;polymerase chain reaction;leukocyte count;echovirus 13

 

数据来源: OVID

 

摘要:

Objective.We assessed epidemiologic, clinical and laboratory features of aseptic meningitis during one season of multiserotype enteroviral meningitis in East Germany in 70 consecutive patients with aseptic meningitis admitted to the Children’s University Hospital Leipzig.Results.Patients, age 1 to 16 years, typically presented with headache, emesis and fever, whereas signs of meningeal irritation were only moderately expressed in one-half of the patients. The median number of leukocytes in the CSF was 151 cells/mm3(range, 2 to 1820) with a high percentage of polymorphonuclear cells (PMNs). Initial blood counts showed mild leukocytosis and pronounced PMN predominance (78.9 ± 1.3%). The percentage of PMNs in the peripheral blood decreased in favor of mononuclear cells after 3 days to a pattern more compatible with viral infection as opposed to that suggestive for bacteria in the beginning. Mean cerebrospinal fluid values of protein, glucose and lactate and the C-reactive protein were mildly elevated or normal. Nonpolio enteroviruses were detected in 30 of 70 patients. Subsequent serotyping revealed echovirus type 13 (13 patients), type 6 (2), type 30 (1) and coxsackie B virus type 5 (2). There were no differences in demographic or clinical data between enterovirus positive and negative patients.Conclusions.Even though individual laboratory values do not solely allow discrimination between viral and bacterial meningitis, the combined epidemiologic, clinical and laboratory data facilitate the diagnosis of aseptic meningitis in most cases. Viral diagnostics, identifying echovirus type 13 that thus far has not been associated with epidemics of meningitis, adds important epidemiologic information.

 

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