A follow-up study of 15 cases of neonatal meningoencephalitis due to Coxsackie virus B5

Farmer, Keitha; Macarthur, Barton A.; Clay, Marie M.

doi:10.1016/s0022-3476(75)80823-7

Cited by 52 publications

(11 citation statements)

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“…Although data on these outcomes are conflicting (11,46,122,134,161) (6). With modern antiviral therapy using acyclovir or vidarabine, mortality has been reduced to 10 to 57%, but up to 86% of the survivors still suffer neurologic sequelae (6).…”

Section: Enterovirusesmentioning

confidence: 99%

Role of the virology laboratory in diagnosis and management of patients with central nervous system disease

1989

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A number of viruses cause acute central nervous system disease. The two major clinical presentations are aseptic meningitis and the less common meningoencephalitis. Clinical virology laboratories are now more widely available than a decade ago; they can be operated on a modest scale and can be tailored to the needs of the patients they serve. Most laboratories can provide diagnostic information on diseases caused by enteroviruses, herpesviruses, and human immunodeficiency virus. Antiviral therapy for herpes simplex virus is now available. By providing a rapid diagnostic test or isolation of the virus or both, the virology laboratory plays a direct role in guiding antiviral therapy for patients with herpes simplex encephalitis. Although there is no specific drug available for enteroviruses, attention needs to be paid to these viruses since they are the most common cause of nonbacterial meningitis and the most common pathogens causing hospitalization for suspected sepsis in young infants in the United States during the warm months of the year. When the virology laboratory maximizes the speed of viral detection or isolation, it can make a significant impact on management of these patients. Early viral diagnosis benefits patients with enteroviral meningitis, most of whom are hospitalized and treated for bacterial sepsis or meningitis or both; these patients have the advantage of early withdrawal of antibiotics and intravenous therapy, early hospital discharge, and avoidance of the risks and costs of unnecessary tests and treatment. Enteroviral infection in young infants also is a risk factor for possible long-term sequelae. For compromised patients, the diagnostic information helps in selecting specific immunoglobulin therapy. Good communication between the physician and the laboratory will result in the most benefit to patients with central nervous system viral infection.

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Section: Enterovirusesmentioning

confidence: 99%

Role of the virology laboratory in diagnosis and management of patients with central nervous system disease

1989

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“…CSF pleocytosis associated with isolation of an enterovirus from a nOn-CSF site is used to make a presumptive diagnosis of enteroviral meningitis (Farmer et al 1975, Singer et al 1980, Jarvis et al 1981, Wilfert et al 1981, Sumaya et al 1982, Wildin and Chonmaitree 1987, Dagan et al 1988). The validity of establishing the diagnosis of CNS enteroviral infection based on these findings has not been carefully examined.…”

Section: Discussionmentioning

confidence: 99%

“…However, this issue was not addressed in the present study, which did not include follow-up developmental and neurological evaluations. Previous reports indicating cognitive and neurological sequelae of enteroviral meningitis in young infants included patients with documented meningitis (positive CSF culture) (Wilfert et al 1981) and 'presumed' meningitis (negative CSF culture with pleocytosis and positive non-CSF culture, 11 to 17 per cent) (Farmer et al 1975, Sells et al 1975. A report of 31 infants with documented enteroviral meningitis demonstrated no significant neurological sequelae (Bergman et al 1987); but more recently, a three-year follow-up of 16 infants who had had enteroviral meningitis during the first three months of life demonstrated subtle deficiencies in IQ and language skills compared with non-infected infants (Gonzalez-del-Rey et al 1991).…”

Section: Problemsmentioning

confidence: 99%

“…Enteroviruses are the most common identified cause of aseptic meningitis, particularly in infants (Meyer et al 1960; Galko et al 1979; Chonmaitree et al i982, 1989; Ponka and Petterson 1982; Wilfert et al 1983; Krugman'et al 1985; Cherry 1987). The evidence for cognitive and neurological sequelae following enteroviral meningitis in young infants is conflicting, and may depend on the diagnostic criteria used (Rantakallio et al 1970b, Farmer et al 1975, Sells et al 1975, Wilfert et al 1981, Bergman et al 1987). Proven enteroviral meningitis is based on isolation of virus from the CSF, or from the brain or meninges at autopsy.…”

mentioning

confidence: 99%

“…When an enterovirus is isolated from a non-CSF site (Le. rectum, throat, nasopharynx, blood) in conjunction with CSF pleocytosis and absence of bacterial pathogens, enteroviral meningitis is the presumptive diagnosis (Farmer et al 1975, Singer et al 1980, Jarvis and Tucker 1981, Wilfert et al 1981, Sumaya andCorman 1982, Wildin andChonmaitree 1987, Dagan ef al. 1988).…”

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confidence: 99%

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Suspect Value of Non‐csf Viral Cultures in the Diagnosis of Enteroviral CNS Infection in Young Infants

Johnson

McAbee

Seaton

et al. 1992

Develop Med Child Neuro

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SUMMARY Laboratory criteria used for presumptive diagnosis of enteroviral meningitis were evaluated as predictors of cerebrospinal fluid (CSF) infection. 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). Predictive value computations demonstrated that no single or combined non‐CSF culture accurately predicted isolation of enteroviruses from the CSF. These results suggest that CSF viral culture is imperative in establishing the diagnosis of enteroviral meningitis in young infants. RÉSUMÉ Valeur de cultures virales hors LCR dans le diagnostic des infections à enterovirus du SNC, chez le nourrisson Les critères de laboratoire utilisés pour une présomption diagnostique de méningite à entérovirus ont étéévalués dans leur capacitéà prédire une infection du liquide céphalo‐rachidien (LCR). Les dossiers de nourrissons âgés de moins de quatre mois, admis à l'hôpital entre 1977 et 1987, avec culture virale du LCR, furent analyses rétrospectivement: une comparaison fut faite entre un groupe 1 avec entérovirus isolé dans le LCR et un groupe 2 avec entérovirus isolés seulement hors LCR. Les calculs de valeur prédictive (PV) démontrèrent qu'aucune culture isolée ou combinée, hors LCR, prédisait correctement l'isolement d'entérovirus dans le LCR. Ces résultats suggèrent que la culture virale du LCR est impérative pour établir le diagnostic de méningite à entérovirus chez le nourrisson. ZUSAMMENFASSUNG Welchen Wert haben Viruskulturen von nicht‐Liquor Material für die Diagnose einer Infektion des Zentralnervensystems durch Enteroviren bei Säuglingen Laborwerte, die zur Verdachtsdiagnose einer enteroviralen Meningitis führten, wurden auf ihre Aussagekraft hinsichtlich einer Liquorinfektion (CSF) untersucht. Die Krankengeschichten von unter vier Monate alien Säuglingen, bei denen in der Zeit von 1977 bis 1987 im Krankenhaus Liquorkulturen angelegt worden waren, wurden retrospektiv analysiert: Kinder, bei denen Enteroviren im Liquor nachgewiesen wurden (Gruppe 1), wurden mit Kindern verglichen, bei denen Enteroviren nur in anderem Material gefunden wurden (Gruppe 2). Beurteilungen des prognostischen Wertes (PV) haben egeben, daß keine einzelne oder kombinierte Kultur von nicht‐Liquor Material mit Sicherheit den Nachweis von Enteroviren im Liquor voraussagen konnte. Diese Ergebnisse zeigen, daß für die Diagnose einer Meningitis durch Enteroviren bei Säuglingen eine Liquorkultur erforderlich ist. RESUMEN Valor de cultivos virales, realizados en puntos no LCR, en el diagnóstico de la infección enteroviral del SNC en lactantes Los criterios de laboratorio usados para el diagnóstico de presunción de una meningitis enteroviral fueron evaluados como predictores de la infección del LCT. Se analizaron retrospectivamente las historias de los lactantes de menos de cuatro meses de edad ingresados en el hospital des...

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Neurologic Infections

Marks

1985

Pediatric Infectious Diseases for the Practitioner

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A follow-up study of 15 cases of neonatal meningoencephalitis due to Coxsackie virus B5

Cited by 52 publications

References 1 publication

Role of the virology laboratory in diagnosis and management of patients with central nervous system disease

Role of the virology laboratory in diagnosis and management of patients with central nervous system disease

Suspect Value of Non‐csf Viral Cultures in the Diagnosis of Enteroviral CNS Infection in Young Infants

Neurologic Infections

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