Clinical and laboratory features of enteroviral meningitis course in adults and children

Authors

DOI:

https://doi.org/10.14739/2310-1210.2017.3.100893

Keywords:

enterovirus infection, aseptic meningitis

Abstract

Objective – to determine the frequency of serous meningitis of enteroviral etiology and find out their clinical and laboratory features.

Materials and Methods. The study included 51 patients with serous meningitis. To confirm the serous meningitis of enteroviral etiology the method of polymerase chain reaction with enteroviruses RNA identification in feces and cerebrospinal fluid and subsequent identification of the enterovirus type 71. The study has been carried out as a part of an open cohort study of the Small Grants Joint Programme WHO/HHWS focused on the programs of the communicable disease control implementation.

Results. Enterovirus etiology of serous meningitis was confirmed in 27 (52.9 %) patients, but the genotype of enterovirus type 71 was not detected in any case. The risk group of serous meningitis of enteroviral etiology development were children aged 8–11 years, as the frequency of serous meningitis of enteroviral etiology among them was 40.8 % against 12.5 % (χ2 = 5.09, p < 0.02) of cases serous meningitis of unknown etiology in the same age group.

Serous meningitis of enteroviral etiology, which was not caused by virus type 71, was characterized by acute onset, less pronounced cerebral symptomatology, dissociation of meningeal signs (48.1 %), neutrophilic pleocytosis (25.9 %) at the beginning of the disease and benign course of the disease due to faster regress in the clinical manifestations of the disease such as headache and meningeal signs.

Conclusions. Enterovirus etiology of serous meningitis was confirmed in 52.9 % of patients but there was not identification of enterovirus genotype 71. Mostly serous meningitis had enterovirus etiology in children of 8–11 years old. Serous meningitis of enteroviral etiology was not caused by virus type 71, and was characterized by acute onset, less severe cerebral symptoms, dissociation of meningeal signs, neutrophilic pleocytosis at the beginning of the disease and benign course of the disease.

 

References

Adams, M. J., King, A. M. Q., & Carstens, E. B. (2013). Ratification vote on taxonomic proposals to the International Committee on Taxonomy of Viruses. Archives of Virology, 158, 2023–2030.

Ooi, M. H., Wong, S. C., Lewthwaite, P., Cardosa, M. J., & Solomon, T. (2010). Clinical features, diagnosis and management of human enterovirus 71 infection. Lancet Neurol., 9(10), 1097–1105. doi: 10.1016/S1474-4422(10)70209-X.

Kemball, C. C., Alirezaei, M., & Whitton, J. L. (2010). Type B coxsackieviruses and their interactions with the innate and adaptive immune systems. Future Microbiol., 9(5), 1329–1347. doi: 10.2217/fmb.10.101.

Duong, V., Mey, C., Eloit, M. Zhu, H., Danet, L., Huang, Z., et al. (2016). Molecular epidemiology of human enterovirus 71 at the origin of an epidemic of fatal hand, foot and mouth disease cases in Cambodia. Emerging Microbes & Infections, 5(9), 104. doi: 10.1038/emi.2016.101.

Khanh, T. H., Sabanathan, S., Thanh, T. T., Thoa, P. K., Thuong, T. C., Hang, V. T., et al. (2012). Enterovirus 71-associated Hand, Foot, and Mouth Disease, Southern Vietnam. Emerg. Infect. Dis., 8(12), 2002–2005. doi: 10.3201/eid1812.120929.

Zeng, M., El Khatib, N. F., Tu, S., Ren, P., Xu, S., Zhu, Q., et al. (2012). Seroepidemiology of Enterovirus 71 infection prior to the 2011 season in children in Shanghai. J. Clin. Virol., 53(4), 285–289. doi: 10.1016/j.jcv.2011.12.025.

Huaman, J. L., Carrion, G., Ampuero, J. S., Ocaña, V., Laguna-Torres, V. A., & Hontz, R. D. (2016). Enterovirus-71 genotype C isolated in Peru between 2006 and 2009. Journal of clinical virology, 85, 40–43. doi: 10.1016/j.jcv.2016.10.023.

Li, W., Gao, H. H., & Zhanq, Q. (2016). Large outbreak of herpangina in children caused by enterovirus in summer of 2015 in Hangzhou, China. Journal of Scientific Reports, 6, 353–388. doi: 10.1038/srep35388.

Logan, S. A. E. (2008). Viral meningitis. BMJ, 7634(336), 36–40.

Pickering, L. K. (2012). Enterovirus (nonpoliovirus) and parechovirus infections (group A and B coxsackieviruses, echoviruses, numbered enteroviruses, and human parechoviruses). Red Book. American Academy of Pediatrics, Elk Grove Village, IL.

Solomon, T., Lewthwaite, P., Perera, D., Cardosa, M. J., McMinn, P., & Ooi, M. H. (2010). Virology, epidemiology, pathogenesis, and control of enterovirus 71. Lancet Infect. Dis., 11(10), 778–790. doi: 10.1016/S1473-3099(10)70194-8.

Zeng, M., El Khatib, N. F., Tu, S., Ren, P., Xu, S., Zhu, Q., et al. (2012). Seroepidemiology of Enterovirus 71 infection prior to the 2011 season in children in Shanghai. J. Clin. Virol., 53(4), 285–289. doi: 10.1016/j.jcv.2011.12.025.

How to Cite

1.
Zadiraka DA, Riabokon EV, Usacheva EV, Kamyshny AМ. Clinical and laboratory features of enteroviral meningitis course in adults and children. Zaporozhye Medical Journal [Internet]. 2017May5 [cited 2024Nov.24];(3). Available from: http://zmj.zsmu.edu.ua/article/view/100893

Issue

Section

Original research