Meningitis víricas neonatales. Importancia de la reacción en cadena de la polimerasa en su diagnóstico

Marcilla-Vazquez, C; Martínez-Gutiérrez, A; Carrascosa-Romero, M.C.; Baquero-Cano, M; Alfaro-Ponce, Berenice

doi:10.33588/rn.6712.2018203

Cited by 10 publications

(12 citation statements)

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“…This is especially true for neonates, in whom it has been reported in 34 to 88% of cases. [37][38][39][40][41] In contrast, pleocytosis can be found in neonates without a central nervous system infection, for example, during gastroenteritis 42 or urinary tract infections. [43][44][45][46] A normal WBC count has also been reported in fungal meningitis.…”

Section: Discussionmentioning

confidence: 99%

Bacterial Meningitis in the Absence of Pleocytosis in Children

Zimmermann

Curtis

2021

Pediatric Infectious Disease Journal

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One of the main features of bacterial meningitis is pleocytosis. However, when children with meningitis present within hours of onset of symptoms, there is the possibility that the meninges are not yet sufficiently inflamed to lead to a raised cerebrospinal fluid (CSF) white blood cell count. A systematic search was done to identify published studies reporting children with culture-or polymerase chain reaction-proven bacterial meningitis in the absence of pleocytosis. We identified 26 studies describing 62 children (18 neonates). In those in whom fever duration was specified, 32 (80%) of 40 had a fever for less than or equal to 24 hours before lumbar puncture (LP). In those in whom the glucose level was reported, it was normal in 14 (82%) of 17 neonates and 33 (80%) of 41 older infants and children. The protein level was normal in 8 (44%) of 17 neonates and 32 (80%) of 40 older infants and children. Twelve of the 62 children had a Gram stain of their CSF and this was positive in 2 (17%). Simultaneous blood cultures were positive in 5 (28%) of 18 neonates and 21 (68%) of 31 older infants and children. There was no association between the absence of pleocytosis and particular bacteria. All of the 10 children who had a second LP had an abnormal CSF including pleocytosis. These findings indicate that the absence of pleocytosis does not exclude bacterial meningitis reliably and should be interpreted in the context of the duration of illness. CSF samples, particularly those from cases with relatively short symptom duration, should be cultured even when the cell count and biochemistry are normal. A second LP can be helpful when bacterial meningitis is suspected despite a normal initial CSF.

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Section: Discussionmentioning

confidence: 99%

Bacterial Meningitis in the Absence of Pleocytosis in Children

Zimmermann

Curtis

2021

Pediatric Infectious Disease Journal

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“…It is not ruled out that they were cases of undiagnosed viral meningitis since they were not intentionally searched for, especially in patients whose CSF cytochemical did not show pleocytosis, proteinorrhachia, or hypoglycorrhachia, since in the study by Marcilla et al 22 , 17 febrile newborns with no apparent source were registered, who had no CSF pleocytosis, no hypoglycorrhachia, and no proteinorrhachia. A diagnosis was reached by performing a polymerase chain reaction (PCR) on CSF.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of meningitis in newborns with fever in a third-level hospital center: Meningitis in febrile newborns

Nieto-Sanjuanero¹,

Díaz-Castillo²,

Sámano-Muciño³

et al. 2022

RMU

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Introduction:Meningitis is an acute inflammatory process of the central nervous system caused by microorganisms affecting the leptomeninges. Cerebrospinal fluid examination should be performed in febrile newborns because of the high risk of meningitis. Objective: The objective of the study was to determine the prevalence of meningitis in febrile newborns at the "Dr. José Eleuterio González" Hospital Universitario. Materials and methods: An observational, descriptive, and retrospective study of neonates admitted to the neonatal intensive care unit with fever. The sample was divided into two groups: Group A (fever/meningitis) and Group B (fever/no meningitis) from January to December 2019. We analyzed maternal and neonatal variables, and cerebrospinal fluid (CSF) biochemical variables, as well as CSF and blood cultures. Results: Sixty-five neonates with fever were included, 37 in Group A and 28 in Group B. In the group with meningitis, we found premature rupture of membranes (PROM) to be 18.9%, with the latency time between rupture and birth being 0.0 (0-120) h (p = 0.03). Regarding the statistically significant variables in the CSF, we found pleocytosis 25 (0-725) cells/mm 3 , elevated CSF proteins 106 (0-478) mg/dl, and lactate 2 (0-0-4.9) mmol/L (p = 0.049). The percentage of bacterial isolation in the meningitis group was 13.5%. Conclusions: The prevalence of meningitis in febrile newborns was 57%, the main risk factor was PROM. Pleocytosis, elevated CSF proteins, and lactate were statistically significant values for diagnosis. The percentage of bacterial isolation in CSF was 13.5%. The mortality was 0%.

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“…Empirical antibiotics were administrated in all infants on admission until bacterial infection could be ruled out. Median duration of antibiotic therapy was 8?days (IQR 6-10, range [4][5][6][7][8][9][10][11][12][13][14], which was also equivalent to the length of stay in hospital. The clinicians in our neonatology tended to decide the duration of antibiotic therapy depending on the duration of fever, serum CRP, and CSF WBC count.…”

Section: Treatment and Clinical Outcomementioning

confidence: 99%

“…[9,10] Neonatal EV infection which mimicked bacterial sepsis can cause serious complications such as myocarditis, meningoencephalitis, acute liver failure, or even death. [11,12] Previous studies revealed that EV infection accounted for about 15% to 40% of the etiology in febrile neonates admitted to hospital, [13,14] and aseptic meningitis is a common clinical type of infection. [15] Hence, an awareness of the clinical characterization of EV infection in neonates may help neonatologists in diagnosing this disease timely.…”

Section: Introductionmentioning

confidence: 99%

Clinical characterization of benign enterovirus infection in neonates

Chen

Dai

2021

Medicine

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Enteroviruses is a group of positive single-stranded RNA viruses ubiquitous in the environment, which is a causative agent of epidemic diseases in children and infants. But data on neonates are still limited. The present study aimed to describe the clinical characteristics of enterovirus infection in neonates and arise the awareness of this disease to general public. Between March 2018 and September 2019, data from all of the neonates diagnosed with enterovirus infection were collected and analyzed from neonatal intensive care unit of Zhangzhou Hospital in Fujian, China. A total of 23 neonates were enrolled. All of them presented with fever (100%), and some with rashes (39.1%). The incidence of aseptic meningitis was high (91.3%), but only a small proportion (28.6%) presented with cerebrospinal fluid (CSF) leukocytosis. The positive value for nucleic acid detection in CSF was significantly higher than throat swab (91.3% vs 43.5%, P = .007). Five of the infected neonates presented with aseptic meningitis (23.8%) underwent brain magnetic resonance imaging examination and no craniocerebral injuries were found. Subsequent follow-ups were performed in 15 of them (71.4%) and no neurological sequelae was found. Aseptic meningitis is a common type of enterovirus infection in neonates with a benign course. Nucleic acid detection of CSF has an important diagnostic value. Febrile neonates would be suggested to screen for enterovirus infection in addition to complete septic workup. An unnecessary initiation or earlier cessation of antibiotics could be considered in enterovirus infection, but that indications still need further studies to guarantee the safety.

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Meningitis víricas neonatales. Importancia de la reacción en cadena de la polimerasa en su diagnóstico

Cited by 10 publications

References 0 publications

Bacterial Meningitis in the Absence of Pleocytosis in Children

Bacterial Meningitis in the Absence of Pleocytosis in Children

Prevalence of meningitis in newborns with fever in a third-level hospital center: Meningitis in febrile newborns

Clinical characterization of benign enterovirus infection in neonates

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