Síndrome da meningite asséptica por enterovírus e Leptospira sp em crianças de Salvador, Bahia

Abstract

For the purpose of identifying the frequency that enterovirus, leptospires, arbovirus cause aseptic meningitis syndrome (AMS) during non-epidemic periods and comparing patients with and without laboratory evidence for an etiologic agent, 112 patients were selected aged between 3 months and 15 years and a clinical suspicion of AMS and were referred to Couto Maia Hospital, the Infectious and Parasitic Disease Reference Center for Salvador, Bahia. In 44.6% (n=50), the etiologic agent for the diagnosis was laboratory-confirmed: enterovirus was identified in 37.7% (n=42) of the cases by the PCR Amplicor diagnostic kit, cerebrospinal fluid or fecal culture isolation; Leptospira sp. in 7.12% (n=8) by the microagglutination test; and arbovirus in non of the cases by inhibition of passive hemagglutination. In 14 of the 22 enteroviral isolates that were evaluated, 6 different serotypes were identified with Echovirus-4 being the major serotype (27.2%; 6/22) among all found (Coxsackie B2, B3, B6 and B9; Enterovirus 71). In conclusion, enteroviruses were the most frequent etiologic agent of AMS and that leptospirosis should be included in the differential diagnosis. In addition, patients with and without laboratory-confirmed identification of the etiologic agent had similar demographic and clinical characteristics and cerebrospinal fluid findings (p >0.05), therefore suggesting that patients without a confirmed diagnosis had enteroviral or leptospiral etiologies.

Evaluation of enterovirus 71 immune status in São Paulo state, Brazil

“…In accordance with the serological data obtained in this study, EV71 isolations in Brazil were very low during the 1999-2005 period 11,18 , as well as in previous times 4,19 . It is worth mentioning that our results correspond to 442 randomly selected samples of sera, obtained from a convenient retrospective sampling from the Enteric Diseases Laboratory, and presenting different symptomatologies.…”

Echovirus 30 associated with cases of aseptic meningitis in state of Pará, Northern Brazil

“…From 2000-2002 in Cyprus, 10 different EV serotypes were detected in 218 cases of enteroviral meningitis, with 55.5% of them caused by Echo 30, 15.2% by Echo 13, 13.8% by Echo 6 and 8.3% by Echo 9 (Richter et al 2006). Six different HEV serotypes were found in Salvador between September 1997-March 2000 in 112 cases of meningitis in which Echo 4 was predominant (Silva et al 2002). It is worth mentioning that in both studies, CSF and faecal samples were used for serotype detection.…”

“…In the past, polioviruses were detected in meningitis cases and Echo 9 was responsible for an outbreak of meningitis that occurred in São Paulo (SP) and Rio de Janeiro (RJ) in 1967and 1978, respectively (Godoy et al 1967, Nery-Guimarães et al 1981. Other serotypes of Echo were found together with coxsackievirus B, EV 71 and no typed EV in cases of meningitis that occurred in three different Brazilian cities: Rio de Janeiro, RJ, Belém, state of Pará (PA) and Salvador, state of Bahia (BA) (Bedoya et al 1998, Gomes et al 2001, Ferreira et al 2002, Silva et al 2002, Lamarão et al 2005, Gomes et al 2007). In Brazil, Echo 30 has been associated with outbreaks and with frequent and sporadic cases of meningitis.…”

RT-PCR for confirmation of echovirus 30 isolated in Belém, Brazil

“…These cells were also used in a study conducted by Silva et al [11], using CSF obtained from patients with meningitis who live in Salvador, Bahia, in northeast Brazil. In these cases, the isolation rate was 7.5% (7/94).…”

“…In Brazil during the 1960s, Godoy et al [8] reported cases of AM associated with enteroviruses. Later studies have confirmed this association [9][10][11][12][13], including two outbreaks of Echo 30 [14,15]. Classic virology methods, using cell culture, are routinely used to detect EV in clinical specimens.…”