Clinical and biological features of enteroviral meningitis among adults and children and factors associated with severity and length of stay

Vareil, Mo; Wille, H.; Kassab, Somar; Le-Cornec, C.; Pugès, Mathilde; Desclaux, A.; Lafon, Marie‐Edith; Tumiotto, C.; Cazanave, Charles; Néau, Didier

doi:10.1016/j.jcv.2018.04.017

Cited by 14 publications

(21 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is recommended that patients diagnosed with infectious encephalitis should receive empiric acyclovir and antibacterial agents until bacterial and viral study results are available [36]. Therefore, prompt identification of a specific pathogen reduces the inappropriate use of antibiotics and antivirals and hospital admission costs [1,2,5,20]. In line with these studies, we show that detection of enteroviruses was associated with shorter hospital stay and lower risk of receiving antibiotics.…”

Section: Discussionsupporting

confidence: 76%

“…However, we did not observe differences in the course of the infection between children diagnosed with the two methods. PCR in stool samples seems to be a reliable alternative to CSF testing in meningitis caused by enteroviruses, which was also shown in other studies [20]. Third, we extrapolated the local incidence of CNS infections in children to calculate annual numbers of cases in Poland, assuming that incidence rates of infections are equal across the country.…”

Section: Discussionmentioning

confidence: 76%

“…In that study, enteroviruses constituted only 15.3% of all viral meningitis cases, which probably explains the low reported incidence rates. The clinical course of meningitis caused by enteroviruses is relatively mild and self-limiting [20]. Hence, enteroviral meningitis might be underdiagnosed and underreported in Poland.…”

Section: Discussionmentioning

confidence: 99%

“…Children with proven enteroviral infection stayed in hospital shorter than did children with the CNS infections of all other etiologies. The usage of antibiotics was associated with higher median duration of hospital stay in children diagnosed with CNS infection caused by enteroviruses (median 7 (7-9) vs. median 11 (8)(9)(10)(11)(12)(13); p = 0.003), and in children with probably viral infection of the CNS (median 13 (10)(11)(12)(13)(14) vs. median 18 (17)(18)(19)(20)(21)(22); p < 0.001).…”

Section: Use Of Antibiotics and Acyclovirmentioning

confidence: 99%

See 3 more Smart Citations

Etiology, Clinical Presentation and Incidence of Infectious Meningitis and Encephalitis in Polish Children

Toczyłowski

Bojkiewicz

Barszcz

et al. 2020

JCM

View full text Add to dashboard Cite

Little is known about the causes and the frequency of meningitis and encephalitis in Poland. We did a retrospective single-center cohort study of children under 18 years old hospitalized with infectious meningitis or encephalitis. Incidence rates were calculated using collected data from patients from the North-East Poland only. A total of 374 children hospitalized between 1 January 2015 and 31 December 2019 were included in the study. A total of 332 (89%) children had meningitis, and 42 (11%) had encephalitis. The etiology of the infection was established in 331 (89%) cases. Enteroviruses accounted for 224 (60%) of all patients. A total of 68 (18%) cases were tick-borne infections. Bacterial pathogens were detected in 26 (7%) children. The median length of hospital stay for children with enteroviral meningitis was 7 days (IQR 7–9), increasing to 11 days (8–13) in those treated with antibiotics. The incidence of meningitis was estimated to be 32.22 (95% CI, 25.33–40.98) per 100,000 and that of encephalitis to be 4.08 (95% CI, 2.07–8.02) per 100,000. By the broad use of molecular diagnostic methods, we managed to identify etiology of the infection in the majority of children. Our data suggest that thorough diagnostics of central nervous system infections are needed to rationalize treatment.

show abstract

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Use Of Antibiotics and Acyclovirmentioning

confidence: 99%

See 2 more Smart Citations

Etiology, Clinical Presentation and Incidence of Infectious Meningitis and Encephalitis in Polish Children

Toczyłowski

Bojkiewicz

Barszcz

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…Similar benefits from the availability of a positive rapid EV PCR in shortening LOS and reducing unnecessary procedures and further tests were demonstrated in a single center French study involving 172 patients (adults and children) . A French study with 69/442 (15.6%) patient samples showed that after positive EV PCR results became available, 63% of children were discharged immediately and 95% within 24 hours .…”

Section: Discussionmentioning

confidence: 60%

Screening for enteroviral meningitis in infants and children—Is it useful in clinical practice?

Turner

Brayley

Downing

et al. 2019

Journal of Medical Virology

View full text Add to dashboard Cite

Enteroviral meningitis in infants and children commonly leads to hospital admission. Diagnosing viral meningitis can be difficult clinically. We examined the usefulness of enteroviral polymerase chain reaction (PCR) testing using cerebrospinal fluid (CSF) samples on clinical practice by comparing positive enteroviral CSF PCR cases (n = 39/136) to negative controls using both clinical outcomes and laboratory parameters. A positive result correlated with a reduced admission to high dependency unit, reduced the duration of antibiotics and a shorter length of stay (P < .05). Adjusted CSF white cell count > 5/μL correlated with positive PCR (P < .05) but would have missed 32% of cases of enteroviral meningitis. Following these findings, an algorithm for the management of suspected viral meningitis has been introduced.

show abstract

The impact of cerebrospinal fluid viral polymerase chain reaction testing on the management of adults with viral meningitis: A multi‐center retrospective study

Kim

Gulholm

Lennard

et al. 2022

Journal of Medical Virology

View full text Add to dashboard Cite

The aim of this study was to evaluate the role of viral polymerase chain reaction (PCR) testing in patients with aseptic meningitis and identify opportunities for improvement in clinical management. All cerebrospinal fluid samples collected in 1 year from four teaching hospitals in Sydney, Australia, were reviewed. Patients with aseptic meningitis were selected, and clinical and diagnostic features, hospital length of stay (LOS), and treatment were analyzed. Identifying a cause by viral PCR did not reduce hospital LOS (median 3 days) or antibiotic use (median 2 days), but the turnaround time of the PCR test correlated with LOS (Rs = 0.3822, p = 0.0003). Forty‐one percent of patients received intravenous acyclovir treatment, which was more frequent in patients admitted under neurologists than infectious diseases physicians (56% vs. 24%; p = 0.013). The majority of patients did not have investigations for alternative causes of aseptic meningitis such as human immunodeficiency virus and syphilis if the viral PCR panel was negative. The benefit of PCR testing in aseptic meningitis in adults in reducing LOS and antibiotic use is unclear. The reasons for unnecessary aciclovir use in meningitis syndromes require further assessment.

show abstract

Clinical and biological features of enteroviral meningitis among adults and children and factors associated with severity and length of stay

Cited by 14 publications

References 20 publications

Etiology, Clinical Presentation and Incidence of Infectious Meningitis and Encephalitis in Polish Children

Etiology, Clinical Presentation and Incidence of Infectious Meningitis and Encephalitis in Polish Children

Screening for enteroviral meningitis in infants and children—Is it useful in clinical practice?

The impact of cerebrospinal fluid viral polymerase chain reaction testing on the management of adults with viral meningitis: A multi‐center retrospective study

Contact Info

Product

Resources

About