Cerebrospinal Fluid White Blood Cell Counts and Lactic Acid Dehydrogenase in Enterovirus Type 71 Meningitis

Goldberg, Frederick; Weiner, Leonard B.

doi:10.1177/000992288102000505

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…Our results are conflicting regarding typical CSF in EV-A71 CNS infection. In one study in children with EV-A71 meningitis, CSF showed a neutrophil predominance in 64% of cases and >200 WBC/ mm 3 in 25% (Goldberg and Weiner, 1981) In a case series of 29 children with EV-A71 fatal infections, lymphocytic predominance was reported in 11/12 patients with pleiocytosis on lumbar puncture (Chan et al, 2000). Our results confirm previous findings on the association between EV-A71 related pulmonary oedema and high neutrophil count or hyperglycemia (Chang et al, 1999;Lin et al, 2002) but also highlights the higher rate of neutrophilic CSF in PO patients and lymphocytic CSF in encephalitis patients .…”

Section: Discussionmentioning

confidence: 94%

A prospective, comparative study of severe neurological and uncomplicated hand, foot and mouth forms of paediatric enterovirus 71 infections

Crabol

Pean

Mey

et al. 2017

International Journal of Infectious Diseases

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Section: Discussionmentioning

confidence: 94%

A prospective, comparative study of severe neurological and uncomplicated hand, foot and mouth forms of paediatric enterovirus 71 infections

Crabol

Pean

Mey

et al. 2017

International Journal of Infectious Diseases

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“…CSF glucose content is usually normal but can be diminished in up to 18% of cases (137,157). The measurement of CSF concentrations of C-reactive protein, lactic acid dehydrogenase, and alpha interferon to differentiate between bacterial and viral meningitis is not generally feasible, although some studies suggest that these tests may be helpful (1,2,34,50,62,111).…”

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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“…Non-specific assays such as c-reactive protein (Corral1 et af. 1981, Peltola 1982) and lactic acid dehydrogenase (Goldberg and Weiner 1981) have been proposed as means of determining viral versus bacterial etiology of meningitis. However, these have not been found sensitive or specific enough to gain routine use in the management of infants with meningitis (Chonmaitree et a/.…”

Section: Problemsmentioning

confidence: 99%

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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Cerebrospinal Fluid White Blood Cell Counts and Lactic Acid Dehydrogenase in Enterovirus Type 71 Meningitis

Cited by 6 publications

References 8 publications

A prospective, comparative study of severe neurological and uncomplicated hand, foot and mouth forms of paediatric enterovirus 71 infections

A prospective, comparative study of severe neurological and uncomplicated hand, foot and mouth forms of paediatric enterovirus 71 infections

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

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