Korean J Pediatr.  2015 Nov;58(11):446-450. 10.3345/kjp.2015.58.11.446.

Analysis of clinical information and reverse transcriptase-polymerase chain reaction for early diagnosis of enteroviral meningitis

• Jin D
• Heo TH
• Byeon JH
• Kim GH
• Kim MK
• Eun SH
• Eun BL

• KMID: 2129738
• DOI: http://doi.org/10.3345/kjp.2015.58.11.446

Abstract

PURPOSE
Meningitis is among the most common infections affecting the central nervous system. It can be difficult to determine the exact pathogen responsible for the infection and patients are often treated with empiric antibiotics. This study was conducted to identify the most common clinical characteristics of enteroviral meningitis in children and evaluate the diagnostic efficacy of reverse transcriptase-polymerase chain reaction (RT-PCR) for early detection of an enterovirus.
METHODS
We analyzed the medical records of children admitted to Korea University Medical Center and diagnosed with meningitis on the basis of cerebrospinal fluid (CSF) analysis and RT-PCR from CSF and other samples from January 2010 to August 2013.
RESULTS
A total of 333 patients were enrolled and classified into four groups based on diagnosis: enteroviral meningitis (n=110), bacterial meningitis (n=23), other viral meningitis (n=36), and unknown etiology (n=164). Patients with bacterial meningitis were younger than those in the other groups (P<0.001). Pleocytosis in CSF was similar across all groups. Of patients in the enteroviral meningitis group, 92.7% were diagnosed based on RT-PCR findings. Mean length of hospital stay for patients with enteroviral meningitis was 6.08 days, which was significantly shorter than that for patients with meningitis of bacterial etiology (19.73 days, P<0.001).
CONCLUSION
Diagnosis of enteroviral meningitis before viral culture results are available is possible using RT-PCR. Accurate diagnosis reduces the length of hospital stay and helps to avoid unnecessary empiric antibiotic treatment.

Keyword

Meningitis; Enterovirus; Reverse transcriptase polymerase chain reaction; Cerebrospinal fluid

MeSH Terms

Academic Medical Centers
Anti-Bacterial Agents
Central Nervous System
Cerebrospinal Fluid
Child
Diagnosis
Early Diagnosis*
Enterovirus
Humans
Korea
Length of Stay
Leukocytosis
Medical Records
Meningitis*
Meningitis, Bacterial
Meningitis, Viral
Reverse Transcriptase Polymerase Chain Reaction
Anti-Bacterial Agents