The Presence of Viral Meningitis without Pleocytosis among Pediatric Patients » Herpes Secrets

A repeat LP showed 130 WBC/μL with 85% neutrophils, 120 RBC/μL, protein of 157 mg/dL, and glucose of 36 mg/dL. A total of 149 children were infected with EV. Clinical data was retrospectively extracted from the hospital files (deputy of research committee approval code 86013). Overall, we collected 58 CSF samples (35 neonates and 23 children) during six months. We determined length of stay by calculating the number of days each patient was in the hospital at midnight. Microscopic and biochemical analysis of the CSF samples namely fungi and bacteria cultures and determination of glucose and proteins levels were carried out. We ensured complete capture of children with bacterial meningitis by cross-checking each institution’s microbiology logs and by including all patients with CSF cultures growing bacterial pathogens (5 patients with bacterial meningitis were not identified by ICD-9 codes).

Records were retrospectively analysed of infants under four months of age admitted to hospital between 1977 and 1987 with viral CSF cultures: those with enteroviruses isolated from CSF (group 1) were compared with those with enteroviruses isolated only from non-CSF sites (group 2). Of the 1,706 specimens submitted for EV RT-PCR during the three study seasons, 570 (33.4%) tested positive and 1,136 (67%) tested negative. Approval was granted by the Human Ethics Committee of the Western Sydney Area Health Service. Patients were distributed as follows: 19 (12%) were neonates (median age, 21 days; range, 9–28 days), 27 (17%) were infants (median age, 40 days; range, 30–458 days), 57 (37%) were children (median age, 6 years; range, 2–15 years), and 53 (34%) were adults (median age, 31 years; range, 17–57 years). The purpose of this study was to explore the usefulness of BMS in South Korean patients, and to introduce BMS as a CPR. Viral CSF culture consisted of one culture tube each of MRC-5 fibroblasts, human neonatal kidney cells, and primary African green monkey kidney cells. P value less than 0.05 was regarded as statistical significance.


We collected data from the medical records regarding patient demographics, medical history, symptoms at presentation to the ED, vital signs at triage, ED physical examination findings, presence of concomitant diseases, and ED disposition. viral meningitis, respectively (p < 0.001 for all comparisons): white cell count (median 1333 vs. Consequently, they require emergency care, including the administration of appropriate antimicrobial therapy as soon as possible once bacterial meningitis is suspected or proven. A detailed history and physical examination can provide a clue to the etiologic diagnosis. Protein levels were 2.97 g/l, glucose 3.2 mmol/l (contemporary plasma values were not available), white cell count (WCC) 145 (lymphocytes 97%, atypical cells 2%, polymorphonuclear cells 1%), red blood cells (RBC) 11 440. Five had symptoms of fever, chills, nausea, and vomiting. The infection may give rise to different symptoms by affecting organs such as the skin, joints, heart muscle or nervous system [3] - [5] . Enteroviruses may cause up to 90% of aseptic meningitis cases for which a specific etiology is identified. In general, patients with aseptic meningitis syndrome are alert and complain of severe headache, primarily when they turn their eyes to one side or the other or flex their necks. Levels of CSF glucose rose with increasing levels of serum glucose (Figure 1 ). Prior studies either did not perform viral testing, only tested a small subset of patients for viral co-infection, or did not evaluate children during the enterovirus season3-8. To complete the CME questions you must have an account in the Vanderbilt CME database. Two patients were treated with intravenous methylprednisolone; the other 2 children were observed carefully without any special therapy. In endemic areas, dengue infection should be considered as a probable etiological agent of meningitis. Areas under receiver-operator-characteristic curves (AROCs) for the resultant score were 0.98 for the derivation set and 0.90 and 0.97, respectively, for validation sets from Columbus and Boston. The concentrations of IFN-γ and IL-1 differed significantly only between the mumps group and control. Resolution occurs several days after drug discontinuation and the clinical and cerebrospinal fluid profile (neutrophilic pleocytosis) do not allow DIAM to be distinguished from infectious meningitis. In this situation, it is better to initiate treatment before the results of the CSF culture are available. Given the significant morbidity and mortality associated with acute bacterial meningitis in the United States and throughout the world, accurate information is necessary regarding the important etiological agents and populations at risk to initiate public health measures and ensure appropriate management. The publisher's final edited version of this article is available at J Neurol Sci See other articles in PMC that cite the published article. The cell count ranges from 10 to 1000 cells/mm3, but is usually less than 300 cells/mm3 (Meyers and Gurtman 1990). A description of 7 consecutive patients admitted for various forms of neurological impairment. This article has been cited by other articles in PMC.