Multicenter prospective surveillance study of viral agents causing meningoencephalitis

Abstract

The frequency of bacterial factors causing central nervous system infections has decreased as a result of the development of our national immunization program. In this study, it is aimed to obtain the data of our local surveillance by defining the viral etiology in cases diagnosed with meningoencephalitis for 1 year. Previously healhty 186 children, who applied with findings suggesting viral meningoencephalitis to 8 different tertiary health centers between August 2018 and August 2019, in Istanbul, were included. The cerebrospinal fluid (CSF) sample was evaluated by polymerase chain reaction. The M:F ratio was 1.24 in the patient group, whose age ranged from 1 to 216 months (mean 40.2 ± 48.7). Viral factor was detected in 26.8%. Enterovirus was the most common agent (24%) and followed by Adenovirus (22%) and HHV type 6 (22%). In the rest of the samples revealed HHV type 7 (10%), EBV (6%), CMV (6%), HSV type 1 (6%), Parvovirus (4%) and VZV (2%). The most common symptoms were fever (79%) and convulsions (45.7%). Antibiotherapy and antiviral therapy was started 48.6% and 4% respectively. Mortality and sequela rate resulted 0.53% and 3.7%, respectively. This highlights the importance of monitoring trends in encephalitis in Turkey with aview to improving pathogen diagnosis for encephalitis and rapidly identifying novel emerging encephalitis-causing pathogens that demand public health action especially in national immunisation programme.

Investigation of the Etiological Causes of Central Nervous System Infection in Children with Multiplex PCR

“…14 In a multicenter prospective study in our country, in which Törün et al investigated viral agents that cause meningoencephalitis in children, the most common viral causes were determined as enterovirus (24%), adenovirus (22%), and HHV-6 (22%), respectively. 15 In another study conducted in our country, Feyzioğlu et al examined herpesviruses in CNS infections and identified HSV-1 and VZV as the causative agents of aseptic meningitis at a rate of 5 and 3.3%, respectively. 16 In a study conducted on 374 Polish pediatric patients with CNS infection, it was observed that enteroviruses were responsible for 60% of the cases.…”

Hybrid capture shotgun sequencing detected unexpected viruses in the cerebrospinal fluid of children with acute meningitis and encephalitis

“…Clinical judgment is crucial in determining the clinical significance of HHV-7 detection in the CSF. In a multicentre prospective surveillance study of viral agents causing meningoencephalitis, HHV-7 and EBV were found in 10% and 6% of cases, respectively [ 26 ]. Again, the role of EBV as a cause of CNS disease must be deduced from its clinical setting.…”

Unspecified Meningoencephalitis with Empiric Antimicrobial Therapy: A Case Report

“…The most common causative bacteria is Streptococcus pneumoniae, group B Streptococcus, Neisseria meningitidis, Haemophilus influenzae, [1][2][3] while the most common viral causes are non-polio enteroviruses (group B coxsackievirus and echovirus), mumps, Parechovirus, Herpesviruses (including Epstein Barr virus, Herpes simplex virus, and Varicellazoster virus), measles, influenza, and arboviruses (West Nile, La Crosse, Powassan, Jamestown Canyon). [2], [4][5][6][7] Meningitis infection was first described in 1828. In 1990 there were 2.5 million cases worldwide and increased to 2.82 million cases in 2016 globally.…”