scholarly journals Laboratory surveillance of viral meningitis by examination of cerebrospinal fluid in Cape Town, 1981–9

1993 ◽  
Vol 111 (2) ◽  
pp. 357-371 ◽  
Author(s):  
J. P. McIntyre ◽  
G. A. Keen
Keyword(s):  
Cerebrospinal Fluid ◽  
Aseptic Meningitis ◽  
Laboratory Data ◽  
Cape Town ◽  
Viral Meningitis ◽  
Laboratory Surveillance ◽  
Coxsackie B

SummaryNine years accumulated laboratory data derived from the culture of the cerebrospinal fluid of 11 360 aseptic meningitis cases were retrospectively reviewed to establish the epidemiology of viral meningitis in Cape Town. Virus was isolated from 3406 of the cases (91% enteroviruses and 9% mumps).Five major summer viral meningitis episodes were documented: two of echovirus 4 (706 and 445 cases), echovirus 9 (223), coxsackie A9 (104) and one of unidentified enterovirus (324 cases – probably echo 9). Although coxsackie B was endemic, clusters of one or other type were dominant at any one time. Mumps was endemic. Sixty-two percent of all viral cases were <5 years old. The median ages of 4 and 5 years in echoviruses 9 and 4 (the epidemic strains) contrasted with that of 1 year in coxsackie B (with many cases <3 months old). Mumps peaked at 3–4 years of age. Males dominated overall, particularly in mumps.

scholarly journals The Prevalence of Viruses in the Cerebrospinal Fluid of Children with Aseptic Meningitis in Shiraz, Iran

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Anahita Sanaei Dashti ◽  
Masoomeh Khalifeh ◽  
Elham Yousefifar ◽  
Mohammad Rahim Kadivar ◽  
Marzieh Jamalidoust ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Real Time ◽  
Aseptic Meningitis ◽  
Real Time Pcr ◽  
Laboratory Data ◽  
Rapid Test ◽  
Viral Meningitis ◽  
Common Causes ◽  
Causative Agents ◽  
Meningitis In Children

Objectives: The current study aimed to evaluate the causative agents of viral meningitis through real-time PCR among children with aseptic meningitis. Methods: Children aged 1 month to 16 years with suspected viral meningitis were enrolled in this study (March 2014-February 2015). Cerebrospinal fluid samples were analyzed by real-time PCR for detection of enterovirus, mumps, measles, adenovirus, EBV, CMV, VZV, hhv 6, and rubella viruses. Demographic information, laboratory data, and clinical presentations of patients were also collected. Results: Of 56 patients suspected to viral meningitis, 21 (38.9 %) had a positive PCR result. Enterovirus (42.85%) and mumps (38.1%) were the most prevalent viruses, and VZV and measles were not detected. Three children were coinfected with enterovirus/hhv6, enterovirus/EBV, and mump/adenovirus. Fever, headache, and nausea/vomiting were the most common symptoms in children. The rates of symptoms were not statistically significant among children with positive and negative PCR tests. Conclusions: In the present study Enterovirus and mumps viruses were the most common causes of viral meningitis in children. PCR, as a rapid test for the diagnosis of viral meningitis, can be used to decrease hospitalization length.

scholarly journals Comparison of enterovirus detection in cerebrospinal fluid with Bacterial Meningitis Score in children

2017 ◽  
Vol 15 (2) ◽  
pp. 167-172 ◽  
Author(s):  
Frederico Ribeiro Pires ◽  
Andréia Christine Bonotto Farias Franco ◽  
Alfredo Elias Gilio ◽  
Eduardo Juan Troster
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Aseptic Meningitis ◽  
Medical Records ◽  
Pediatric Patients ◽  
Tertiary Hospital ◽  
Viral Meningitis ◽  
Parenteral Antibiotic ◽  
Score Analysis

ABSTRACT Objective To measure the role of enterovirus detection in cerebrospinal fluid compared with the Bacterial Meningitis Score in children with meningitis. Methods A retrospective cohort based on analysis of medical records of pediatric patients diagnosed as meningitis, seen at a private and tertiary hospital in São Paulo, Brazil, between 2011 and 2014. Excluded were patients with critical illness, purpura, ventricular shunt or recent neurosurgery, immunosuppression, concomitant bacterial infection requiring parenteral antibiotic therapy, and those who received antibiotics 72 hours before lumbar puncture. Results The study included 503 patients. Sixty-four patients were excluded and 94 were not submitted to all tests for analysis. Of the remaining 345 patients, 7 were in the Bacterial Meningitis Group and 338 in the Aseptic Meningitis Group. There was no statistical difference between the groups. In the Bacterial Meningitis Score analysis, of the 338 patients with possible aseptic meningitis (negative cultures), 121 of them had one or more points in the Bacterial Meningitis Score, with sensitivity of 100%, specificity of 64.2%, and negative predictive value of 100%. Of the 121 patients with positive Bacterial Meningitis Score, 71% (86 patients) had a positive enterovirus detection in cerebrospinal fluid. Conclusion Enterovirus detection in cerebrospinal fluid was effective to differentiate bacterial from viral meningitis. When the test was analyzed together with the Bacterial Meningitis Score, specificity was higher when compared to Bacterial Meningitis Score alone.

scholarly journals Point-of-care Cerebrospinal Fluid Gram Stain For the Management of Acute Meningitis in Adults: A Retrospective Observational Study

2020 ◽  
Author(s):  
Tomohiro Taniguchi ◽  
Sanefumi Tsuha ◽  
Soichi Shiiki ◽  
Masashi Narita
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Observational Study ◽  
Aseptic Meningitis ◽  
Point Of Care ◽  
Laboratory Data ◽  
Retrospective Observational Study ◽  
Antibiotic Administration ◽  
Gram Stain ◽  
Acute Meningitis

Abstract Background: Gram staining of cerebrospinal fluid (CSF) is widely used in the diagnosis of acute meningitis, but is often conducted in the laboratory, as only some hospitals have access to point-of-care Gram stain (PCGS). The purpose of this study was to demonstrate the clinical impact and utility of PCGS in diagnosing and treating both bacterial and aseptic meningitis in adults. Methods: This was a hospital-based, retrospective observational study at a referral center in Okinawa, Japan. We reviewed the records of all patients aged 15 years or older who were admitted to the Division of Infectious Diseases between 1995 and 2015 and finally diagnosed with bacterial (n=34) or aseptic meningitis (n=97). For bacterial meningitis, we compared the treatments that were actually selected based on PCGS with simulated treatments that would have been based on the Japanese guidelines. For aseptic meningitis, we compared the rates of antibiotic use between real cases where PCGS was available and real cases where it was not. Results: PCGS was the most precise predictor for differentiating between bacterial and aseptic meningitis (sensitivity 91.2%, specificity 98.9%), being superior in this regard to medical histories, vital signs and physical examinations, and laboratory data available in the emergency room. In bacterial meningitis, PCGS reduced the frequency of meropenem use (1/34=3.0%) compared with simulated cases in which PCGS was not available (19/34=55.9%) (p=0.000). In real aseptic meningitis cases, the rate of antibiotic administration was lower when PCGS was used (38/97=39.2%) than when it was not (45/74=60.8%) (p=0.006). Conclusions: PCGS of CSF distinguishes between bacterial and aseptic meningitis more accurately than other predictors available in the ER. Patients are more likely to receive narrower-spectrum antimicrobials when PCGS is used than when it is not. PCGS of CSF thus can potentially suppress the empiric use of antimicrobials for aseptic meningitis.

scholarly journals Point-of-care cerebrospinal fluid Gram stain for the management of acute meningitis in adults: a retrospective observational study

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Tomohiro Taniguchi ◽  
Sanefumi Tsuha ◽  
Soichi Shiiki ◽  
Masashi Narita
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Observational Study ◽  
Aseptic Meningitis ◽  
Point Of Care ◽  
Laboratory Data ◽  
Retrospective Observational Study ◽  
Antibiotic Administration ◽  
Gram Stain ◽  
Acute Meningitis

Abstract Background Gram stain of cerebrospinal fluid (CSF) is widely used in the diagnosis of acute meningitis, however, it is often conducted in the laboratory, as only some hospitals have access to point-of-care Gram stain (PCGS). The purpose of this study was to demonstrate the clinical impact and utility of PCGS in diagnosing and treating both bacterial and aseptic meningitis in adults. Methods This was a hospital-based, retrospective observational study at a referral center in Okinawa, Japan. We reviewed the records of all patients aged 15 years or older who were admitted to the Division of Infectious Diseases between 1995 and 2015 and finally diagnosed with bacterial (n = 34) or aseptic meningitis (n = 97). For bacterial meningitis, we compared the treatments that were actually selected based on PCGS with simulated treatments that would have been based on the Japanese guidelines. For aseptic meningitis, we compared the rates of antibiotic use between real cases where PCGS was available and real cases where it was not. Results PCGS was the most precise predictor for differentiating between bacterial and aseptic meningitis (sensitivity 91.2%, specificity 98.9%), being superior in this regard to medical histories, vital signs and physical examinations, and laboratory data available in the emergency room (ER). In bacterial meningitis, PCGS reduced the frequency of meropenem use (1/34 = 3.0%) compared with simulated cases in which PCGS was not available (19/34 = 55.9%) (p< 0.001). In aseptic meningitis cases, the rate of antibiotic administration was lower when PCGS was used (38/97 = 39.2%) than when it was not (45/74 = 60.8%) (p = 0.006). Conclusions PCGS of CSF distinguishes between bacterial and aseptic meningitis more accurately than other predictors available in the ER. Patients with bacterial meningitis are more likely to receive narrower-spectrum antimicrobials when PCGS is used than when it is not. PCGS of CSF thus can potentially suppress the empiric use of antimicrobials for aseptic meningitis.

scholarly journals Echovirus type 11 infection in Melbourne–1953 to 1980

1981 ◽  
Vol 87 (2) ◽  
pp. 305-312 ◽  
Author(s):  
M. L. Kennett ◽  
A. Donaldson ◽  
J. A. Marshall ◽  
H. G. Williamson
Keyword(s):  
Electron Microscopy ◽  
Cerebrospinal Fluid ◽  
Cell Line ◽  
Aseptic Meningitis ◽  
Respiratory Infections ◽  
Respiratory Illness ◽  
Viral Meningitis ◽  
Immune Electron Microscopy ◽  
Reception Centre ◽  
Echovirus Type

SummaryEchovirus type 11 (echo 11) has been isolated at the virus laboratory of Fairfield Hospital, Melbourne, Australia, in 20 of the 28 years since the laboratory was established. During this time two major epidemics have occurred; the first, in 1971–2 involved 90 patients with aseptic meningitis or respiratory illness. The second began in June 1979 and lasted for 11 months, during which echo 11 was isolated from 174 patients admitted to Fairfield Hospital, other Victorian and Tasmanian hospitals and a children's reception centre. The patients' illnesses included viral meningitis (66%), fever (10%), respiratory infections (7%) and gastroenteritis (2%). One baby died.Echo 11 was recovered from nasopharyngeal swabs or aspirates, cerebrospinal fluid and faecal specimens and was isolated most frequently in the Borrie cell line. Isolates were readily identified by immune electron microscopy and/or neutralization tests.

scholarly journals Cerebrospinal fluid procalcitonin: a promising diagnostic tool in differentiating bacterial from aseptic meningitis

2019 ◽  
Vol 6 (5) ◽  
pp. 1807
Author(s):  
Mudasir Ahmad ◽  
Syed Wajid Ali ◽  
Javeed Iqbal ◽  
Feroz Ahmad Wani ◽  
Javeed Ahmad
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Aseptic Meningitis ◽  
Diagnostic Marker ◽  
Statistical Tests ◽  
Viral Meningitis ◽  
Jammu And Kashmir ◽  
The Mean ◽  
Control Prospective Study

Background: Procalcitonin in cerebrospinal fluid has been evaluated with regard to its usefulness in distinguishing between the possible causative organisms for infections. CSF PCT as a diagnostic marker has also been evaluated for differentiating bacterial from viral meningitis with conflicting results obtained so far. The current study was designed to see the role of procalcitonin as diagnostic marker and in differentiating bacterial from aseptic meningitis in pediatric age group.Methods: Children from 5 months to 15 years of age who were suspected cases of meningitis and were admitted to Pediatric Department in SKIMS Srinagar, Jammu and Kashmir were included in this case control prospective study conducted from 2014 to 2016. The total number of 200 children participated in the study among which 100 were cases and 100 controls. Serum and CSF PCT was measured by a fluorescence immunoassay using QDX Instacheck with a detection limit of 0.25-100 ng/ml. Data was analyzed by using standard statistical tests using SPSS 20.Results: The mean CSF PCT in ng/ml in our study for viral meningitis was 0.59±0.43 (range=0.00-1.90), for bacterial meningitis 4.92±1.50 (range=2.89-10.82) and for controls 0.22±0.11 (range=0.00-0.32), respectively. CSF PCT was significantly higher in viral and bacterial meningitis as compared to controls (p<0.01) and significantly higher in bacterial meningitis as compared to viral meningitis (p<0.01). An AUC of 1.000 was established using serum and CSF PCT for bacterial meningitis. The diagnostic accuracy of serum and CSF PCT was almost 100% at cut-off of 2.2 ng/ml and 2.89 ng/ml, respectively.Conclusions: Author have concluded that CSF PCT can be used as a diagnostic marker with better results in differentiation of bacterial from aseptic meningitis. 

Neurotrophin-3 Levels in Cerebrospinal Fluid From Children With Bacterial Meningitis, Viral Meningitis, or Encephalitis

2000 ◽  
Vol 15 (1) ◽  
pp. 19-21 ◽  
Author(s):  
Yumi Mizuno ◽  
Hidetoshi Takada ◽  
Kyoko Urakami ◽  
Kenji Ihara ◽  
Ryutaro Kira ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Viral Meningitis ◽  
Neurotrophin 3

Isolation of Parainfluenza Virus Type 3 from Cerebrospinal Fluid Associated with Aseptic Meningitis

1993 ◽  
Vol 99 (6) ◽  
pp. 705-707 ◽  
Author(s):  
Randall D. Craver ◽  
Robert S. Gohd ◽  
Daniel R. Sundin ◽  
John C. Hierholzer
Keyword(s):  
Cerebrospinal Fluid ◽  
Aseptic Meningitis ◽  
Virus Type ◽  
Parainfluenza Virus ◽  
Type 3

AN EPIDEMIC OF ASEPTIC MENINGITIS SYNDROME DUE TO ECHO VIRUS TYPE 6

PEDIATRICS ◽  
1962 ◽  
Vol 29 (3) ◽  
pp. 418-431
Author(s):  
David T. Karzon ◽  
Norman S. Hayner ◽  
Warren Winkelstein ◽  
Almen L. Barron
Keyword(s):  
Cerebrospinal Fluid ◽  
Aseptic Meningitis ◽  
Virus Type ◽  
Alimentary Tract ◽  
Febrile Illness ◽  
Acute Onset ◽  
Etiologic Agent ◽  
Abdominal Muscles ◽  
Older Children ◽  
Echo Virus

The clinical features of 130 cases of aseptic meningitis syndrome associated with ECHO virus type 6 infection were studied. Characteristically, the onset was acute with the development of fever, headache, muscle pains, and vomiting. A biphasic course was present in 8% of the cases. The physical findings included mild to moderate stiffness or spasm of the neck, back, and posterior thigh muscles. Disturbance in sensorium, cranial nerve involvement, and bulbar signs were conspicuously absent. Absence of deep tendon and superficial reflexes occurred in 16% of the cases. Evidence of mild muscle weakness occurred in 39% of cases, more commonly in the axial rather than peripheral muscles. Most of these patients had bilateral weakness of the anterior neck muscles, but included in the group were five with bilateral weakness of the back or abdominal muscles and six with some involvement of the extremities. Neuromuscular changes were mild and frequently questionable. Where follow-up was available, the changes were usually found to be transient. The effect of age upon the clinical picture was analyzed. Only 3 of 130 patients were less than 4 years of age. Young children had a more acute onset and were admitted to the hospital more promptly than older children and adults. The incidence of pleurodynia was 38% in adults and only 5% in patients less than 20 years of age. The cerebrospinal fluid revealed pleocytosis, with lymphocyte counts ranging from a few cells to 930/mm3. The protein values exceeded 40 mg/100 ml in 48% of the cases, the highest value being 102 mg/100 ml. An undifferentiated febrile illness in household associates of patients with aseptic meningitis, characterized by headache, vomiting and muscle pain, was associated with a high recovery rate of ECHO 6 virus. This is presumably the forme fruste of the fully developed aseptic meningitis syndrome. ECHO 6 virus was recovered from four patients in whom there was evidence of neurologic involvement beyond that seen in the aseptic meningitis syndrome. ECHO 6 virus was the probable etiologic agent in two of these cases. A 15-year-old girl with mild encephalitis marked by disorientation, hallucinations, and weakness of the legs yielded ECHO 6 from her alimentary tract. ECHO 6 was recovered from the cerebrospinal fluid and alimentary tract of a 15-year-old boy with features of the Guillain-Barré syndrome.

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