Soonchunhyang Med Sci.  2015 Jun;21(1):1-4. 10.0000/sms.2015.21.1.1.

The Association between Cerebrospinal Fluid Pleocytosis and Clinical Manifestations of Enteroviral Meningitis in Children

• Ahn H
• Park M
• Lee J
• Hong YH
• Suh ES

• KMID: 1797802
• DOI: http://doi.org/10.0000/sms.2015.21.1.1

Abstract

OBJECTIVE
Enteroviruses are major causes of aseptic meningitis in children. This study aimed to describe the clinical manifestations of enteroviral meningitis according to the presence of cerebrospinal fluid (CSF) pleocytosis, and to investigate the factors influencing the CSF pleocytosis in children with this condition.
METHODS
Eighty children with enteroviral meningitis treated at Soonchunhyang University Hospitals in Seoul and Bucheon between July 2012 and August 2013 were enrolled. The patients were diagnosed by reverse transcription-polymerase chain reaction (RT-PCR), and the clinical variables were compared according to the presence of CSF pleocytosis.
RESULTS
Of the 80 patients, 54 (67.5%) and 26 (32.5%) patients had and did not have CSF pleocytosis, respectively. Forty-eight (60%) patients were male, and the median age was 63 months (range, 2 to 192 months). Seventy-six (95%), 67 (83.7%), 51 (63.7), and 2 (2.5%) patients presented with fever, headache, vomiting, and seizure, respectively. Increased CSF protein and pressure were associated with CSF pleocytosis. However, age, peripheral white blood cell count, C-reactive protein, CSF glucose, CSF/serum glucose ratio, and onset-puncture time interval were not associated with the presence of CSF pleocytosis.
CONCLUSION
This study demonstrated a high proportion of non-pleocytic enteroviral meningitis in children, and identified several clinical manifestations that were associated with CSF pleocytosis. The findings of this study may help us better understand the characteristics of the disease and facilitate early diagnosis and treatment of enteroviral meningitis. During the outbreak seasons of enteroviral meningitis, the importance of continuous surveillance of enteroviruses and rapid RT-PCR testing should be emphasized.

Keyword

Enterovirus; Meningitis; Leukocytosis; Pediatrics

MeSH Terms

C-Reactive Protein
Cerebrospinal Fluid*
Child*
Early Diagnosis
Enterovirus
Fever
Glucose
Gyeonggi-do
Headache
Hospitals, University
Humans
Leukocyte Count
Leukocytosis*
Male
Meningitis*
Meningitis, Aseptic
Pediatrics
Seasons
Seizures
Seoul
Vomiting
C-Reactive Protein
Glucose