Cytokine and Cellular Inflammatory Sequence in Enteroviral Meningitis

Abstract

The inflammatory process observed in human enteroviral meningitis is comparable with that observed in animal models: 1) infection induces proinflammatory cytokine production, followed by infiltration of white blood cells into the infected area, and 2) inflammation is terminated by the anti-inflammatory cytokines that are produced when pathogens are eliminated.

Enteroviral Central Nervous System Infections in Children of the Region of Monastir, Tunisia: Diagnosis, Laboratory Findings of Cerebrospinal Fluid and Clinical Manifestations

“…In the current study, 60 % of EVs positive cases had elevated leukocyte counts in the CSF. In accordance with previous reports, the absence of pleocytosis was frequent in children under 2-years-old [18,20,29,36,50]. Lymphocytes were predominant in 80 % of EVs positive patients.…”

Characteristics of pediatric patients with enterovirus meningitis and no cerebral fluid pleocytosis

“…This may explain the significantly lower WBC count and higher CRP levels in patients with no CSF pleocytosis in this study. The finding that patients with EV meningitis and no CSF pleocytosis did not have a shorter duration of symptoms does not support Sato's hypothesis [22]. This may partly be explained by recollection bias of parents.…”

“…The mechanism to explain the lack of pleocytosis in some patients during EV meningitis is still unclear. Sato et al suggested that young infants with EV meningitis and no CSF pleocytosis may be at an initial stage of illness when, though production of (pro) inflammatory cytokines has been stimulated, the blood leukocytes have not yet infiltrated the cerebrospinal cavity [22]. Kawashima et al observed that only 4 out of 21 patients with EV meningitis had CSF pleocytosis, despite high levels of the inflammatory cytokine, interleukin IL-6, in the CSF at presentation [12].…”

Use of Fluorescence Resonance Energy Transfer for Rapid Detection of Enteroviral Infection In Vivo

“…These viruses are transmitted through the fecal-oral route and can cause an array of clinical manifestations, ranging from mild febrile illness to potentially fatal syndromes including paralytic poliomyelitis, aseptic meningitis, and encephalitis (27,28,40). Enteroviruses pose a public health threat because they are stable in aquatic environments and have low infectious doses (13,14,50).…”