Picornaviruses in cerebrospinal fluid of children with meningitis in Luanda, Angola

Pelkonen, Tuula; Roine, Irmeli; Anjos, Elizabete; Kaijalainen, Svetlana; Roivainen, Merja; Peltola, Heikki; Pitkäranta, Anne

doi:10.1002/jmv.23304

Cited by 19 publications

(11 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In contrast to reports from developed [ 24 ],[ 25 ] and other tropical [ 2 ],[ 26 ],[ 27 ] countries, influenza, adenoviruses and other HHVs were not significant contributors to the burden of encephalopathy in our hospitalized children [ 7 ],[ 28 ]. Epstein-Barr virus, commonly associated with Burkitt’s lymphoma in malaria-endemic areas including PNG [ 29 ],[ 30 ], was not identified in the present study and neither was HHV-8, perhaps because PCR was performed on CSF rather than blood or saliva [ 3 ],[ 31 ].…”

Section: Discussioncontrasting

confidence: 92%

Viral pathogens in children hospitalized with features of central nervous system infection in a malaria-endemic region of Papua New Guinea

Laman

Hwaiwhanje²,

Bona

et al. 2014

BMC Infect Dis

View full text Add to dashboard Cite

BackgroundViral central nervous system (CNS) infections are common in countries where malaria is endemic but, due to limited laboratory facilities, few studies have systematically examined the prevalence and clinical consequences of the presence of viruses in cerebrospinal fluid (CSF) from children with suspected CNS infection.MethodsWe performed a prospective study of Papua New Guinean children hospitalized with signs and symptoms of CNS infection. CSF samples from 300 children without proven bacterial/fungal meningitis were analyzed for human herpes viruses (HHV), picornaviruses, influenza, adenoviruses, flaviviruses and bacteria.ResultsFifty-five children (18%) had viral (42), bacterial (20) or both viral and bacterial (7) nucleic acids (NA) identified in their CSF. Human herpes viruses accounted for 91% of all viruses found. The identification of viral or bacterial NA was not associated with any characteristic clinical features. By contrast, malaria was associated with increased identification of viral and bacterial NA and with impaired consciousness, multiple convulsions and age. Malaria was also inversely associated with an adverse outcome. Amongst children with HHV infection, those with HHV-6 and −7 were younger, were more likely have impaired consciousness and had a higher proportion of adverse outcomes than children with CMV. Dengue and enteroviral infections were infrequent. Adenoviral and influenza infections were not identified.ConclusionInfections with HHV-6, HHV-7, dengue and enterovirus have the potential to cause serious CNS disease in young PNG children. However most HHVs in this malaria-endemic setting should be considered to be the result of reactivation from a latent reservoir without clinical sequelae.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0630-0) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussioncontrasting

confidence: 92%

Viral pathogens in children hospitalized with features of central nervous system infection in a malaria-endemic region of Papua New Guinea

Laman

Hwaiwhanje²,

Bona

et al. 2014

BMC Infect Dis

View full text Add to dashboard Cite

show abstract

“…However, in a study of 142 children with suspected bacterial meningitis, 21 a virus was detected in the CSF of just one patient with more than 1000 white blood cells in the CSF.…”

Section: Discussionmentioning

confidence: 99%

Viral CNS infections in children from a malaria-endemic area of Malawi: a prospective cohort study

Mallewa

Vallely

Faragher

et al. 2013

The Lancet Global Health

View full text Add to dashboard Cite

SummaryBackgroundFever with reduced consciousness is an important cause of hospital admission of children in sub-Saharan Africa, with high mortality. Cerebral malaria, diagnosed when acute Plasmodium falciparum infection and coma are recorded with no other apparent reason, is one important cause. We investigated whether viruses could also be an important cause of CNS infection in such patients, and examined the relative contribution of viral pathogens and malaria parasitaemia.MethodsWe did a prospective cohort study in Blantyre, Malawi. From March 1, 2002, to Aug 31, 2004, we enrolled children aged between 2 months and 15 years who were admitted to hospital with suspected non-bacterial CNS infections. Children with a cerebrospinal fluid (CSF) white cell count of less than 1000 cells per μL and negative bacterial microscopy and culture were deemed to have suspected viral CNS infection. Blood was examined for asexual forms of P falciparum. PCR was done on CSF or on post-mortem brain biopsy specimens to detect 15 viruses known to cause CNS infection.FindingsFull outcome data were available for 513 children with suspected viral CNS infection, of whom 94 (18%) died. 163 children (32%) had P falciparum parasitaemia, of whom 34 (21%) died. At least one virus was detected in the CNS in 133 children (26%), of whom 43 (33%) died. 12 different viruses were detected; adenovirus was the most common, affecting 42 children; mumps, human herpes virus 6, rabies, cytomegalovirus, herpes simplex virus 1, and enterovirus were also important. 45 (9%) of the 513 children had both parasitaemia and viral infection, including 27 (35%) of 78 diagnosed clinically with cerebral malaria. Children with dual infection were more likely to have seizures than were those with parasitaemia alone, viral infection only, or neither (p<0·0001). 17 (38%) of the 45 children with dual infection died, compared with 26 (30%) of 88 with viral infection only, 17 (14%) of 118 with parasitaemia only, and 34 (13%) of 262 with neither (p<0·0001). Logistic regression showed children with a viral CNS infection had a significantly higher mortality than did those who did not have a viral CNS infection (p=0·001).InterpretationViral CNS infections are an important cause of hospital admission and death in children in Malawi, including in children whose coma might be attributed solely to cerebral malaria. Interaction between viral infection and parasitaemia could increase disease severity.FundingWellcome Trust, US National Institutes of Health, and UK Medical Research Council.

show abstract

“…To our knowledge, only 1 study describing presumed bacterial meningitis and a coinfection with different EVs in 4 children has been reported. 5 These mixed infections were infrequent (4% of the 142 tested patients) and the authors concluded that detection of a picornavirus did not affect the clinical picture and outcome of bacterial meningitis. One case of mixed meningitis with isolation of echovirus 9 and Haempophilus influenzae type b, was also described some years ago.…”

Section: Ian D Kane Md Donald H Arnold Mdmentioning

confidence: 95%

Sepsis and Meningitis Caused by Pasteurella Multocida and Echovirus 9 in a Neonate

Aguado

Calvo

Wilhelmi

et al. 2014

Pediatric Infectious Disease Journal

View full text Add to dashboard Cite

Picornaviruses in cerebrospinal fluid of children with meningitis in Luanda, Angola

Cited by 19 publications

References 16 publications

Viral pathogens in children hospitalized with features of central nervous system infection in a malaria-endemic region of Papua New Guinea

Viral pathogens in children hospitalized with features of central nervous system infection in a malaria-endemic region of Papua New Guinea

Viral CNS infections in children from a malaria-endemic area of Malawi: a prospective cohort study

Sepsis and Meningitis Caused by Pasteurella Multocida and Echovirus 9 in a Neonate

Contact Info

Product

Resources

About