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

Abstract

Human enteroviruses (HEV) are one of the major causes of central nervous system (CNS) infections in pediatrics. A prospective study was conducted to assess the epidemiological, clinical, and laboratory characteristics of enterovirus (EV) infections of the CNS in children under 15-years-old, suspected of having viral CNS infections and admitted to the Pediatric Department of Monastir University Hospital, Tunisia. Enteroviral RNA was detected by 5 0 NCR nested RT-PCR assay in 33 % (20 out of 60) of cerebrospinal fluid specimens, whereas only six samples (10 %) were EV positive in cell culture. EV-positive patients were clustered according to their clinical manifestations, predominantly diagnosed as aseptic meningitis (65 %) and meningoencephalitis (20 %). Fever, headache, vomiting, and neck stiffness were the most pronounced symptoms. Pleocytosis with the predominance of lymphocytes was observed in 60 % of EV positive specimens. Although patients suffering from EV infections were encountered throughout the year, most occurred during spring and summer months. Using VP1-2A nested RT-PCR and sequence analysis, three of the 20 positive HEV were identified as Echovirus (E)-9. This is the first report of a cluster of aseptic meningitis cases caused by E-9 in Monastir.

Viral Agents Identified in Cerebrospinal Fluid Samples

“…Pozitif örneklerin ikisi yaz, biri sonbahar, dördü kış ve biri ilkbahar mevsiminde saptanmıştır. EV enfeksiyonla-rının yaz ve erken sonbahar aylarında arttığı bilinmektedir (35)(36)(37) . Bununla birlikte, kış aylarında olgularda artış olduğu bildirilen yayınlar da bulunmaktadır (38,39) .…”

Investigation of the Causative Agents of Meningitis By Real-Time PCR Method

“…El Hiar ve ark. 'nın (26) , SSS enfeksiyonu öntanılı 60 hastadan yaptığı çalışmanın 20'sinde EV pozitifliği görülmüş, bunun da %45'i 0-2 yaş aralığında ve %35'i 2-5 yaş aralığında bulunmuştur. EV yine ilkbahar ve yaz aylarında en sık görülmüştür.…”

Topics and trends in artificial intelligence assisted human brain research

“…For Infant, Fatal & Child, Goto et al [73] proposed an easy-to-use and generally applicable bedside instrument to predict outcomes in children after cardiac arrest. For Virus & Pathology, Hiar et al [74] assessed epidemiological, clinical, and laboratory features of enterovirus infections of central nervous system in children younger than 15 years. For Attention & Vision, with the use of human MEG, Bartsch et al [75] examined whether effects of global feature-based attention were preserved by manipulating the strength and consistency of spatial focusing to the target.…”