Clinical and laboratory characteristics of enteroviral meningitis in children, including qRT-PCR and sequencing analysis.

AIMS: Enteroviruses (EVs) are the most common agents of aseptic meningitis. Some serotypes can cause serious neuroinfection leading to death. The aim of this study was to determine the representation of EVs in the etiology of aseptic meningitis in children and to analyze the demographic, clinical, laboratory, and epidemiological characteristics of patients with EV meningitis. PATIENTS AND METHODS: This was a prospective study including 147 patients in three groups: EV meningitis, tick-borne encephalitis, and aseptic meningitis with unidentified agent. RESULTS: Boys with EV meningitis predominated over girls. The average patient age was 11 years. Compared to the control group, these patients suffered more from stiff back (P=0.010), vomiting and nausea (P=0.009). They had shorter symptom duration (P<0.001), higher C-reactive protein in blood (P<0.001), higher predominance of polynuclears (P=0.026), and greater lactate (P=0.003) in cerebrospinal fluid (CSF). The serotype seen most frequently (68%) was ECHO virus (ECV) 30. CONCLUSIONS: Enteroviruses play the most important role in the differential diagnosis of aseptic meningitis. Short symptom duration, slightly higher inflammatory parameters in blood, predominance of polynuclears, and elevated CSF lactate have predictive value in diagnosing this disease. ECV 30 (frequently the agent of epidemics in the Czech Republic) was the aseptic meningitis agent most often seen.

[Epidemiology, etiology and clinical picture of enteroviral meningitis in children in South Moravia].

OBJECTIVES: Enteroviruses (EVs) are the most common cause of aseptic viral meningitis. In some cases, they can cause severe meningoencephalitis and acute flaccid paralysis - an association with some virulent serotypes. The objectives were to describe the epidemiological situation of EV meningitis in children in South Moravia, to elucidate the etiology including the incidence of virulent serotypes and to evaluate the clinical presentation. MATERIAL AND METHODS: A total of 88 children with EV meningitis were prospectively evaluated. In case of aseptic inflammation in the cerebrospinal fluid, EV was detected using real-time PCR. Genotyping was performed in 56 samples using repeated one-step PCR and partial sequencing on a genetic analyzer in the National Reference Laboratory for Enteroviruses in Prague. RESULTS: The patients' age range was 3-17 years; there were more boys than girls. Two epidemics occurred, one involving 17 Roma children and the other involving 8 swimming pool visitors. The most common symptoms were headache, fever and stiff neck. The most frequently (59%) detected agent was Echovirus 30 identified as the cause of the epidemics. In one boy, EV 71 (virulent serotype) was found. The clinical course did not vary from that in other serotypes. All 88 children recovered without complications. CONCLUSIONS: EVs are an important part of the differential diagnosis of neuroinfections, although most infections are benign aseptic meningitis. The clinical presentation did not vary between infections with various serotypes. Higher incidence rates of virulent serotypes were not reported. Echovirus 30 was detected most frequently and was repeatedly identified as the cause of epidemics throughout the Czech Republic.

[Salmonellosis - a real threat for infants].

Salmonella spp. are a common cause of bacterial gastroenteritis. In infants, Salmonella infection is uncommon, posing a higher risk for a severe course. The authors present a case of a 3-month-old infant with suspected Salmonella sepsis. Also discussed are the correct approach to therapy and potential errors in the treatment of the youngest age groups.