Prevalence of human parechovirus and enterovirus in cerebrospinal fluid samples in children in Jinju, Korea

Wajnsztejn

et al. 2015

J. Hum. Growth Dev.

Abstract:Introduction: Meningitis is the leading infectious syndrome that affects the central nervous system, and most cases are caused by viral infections, mainly enterovirus. The clinical diagnosis for meningitis etiology still presents major challenges. The analysis of polymerase chain reaction (PCR), white blood cells, red blood cells, glucose, protein, and lactate in the cerebrospinal fluid (CSF) provides the first clues to the diagnosis. However, the reference values of some parameters can suffer changes. Objective: Analyze the laboratory parameters of CSF in patients with enterovirus meningitis, and then, theirrelationship by age group. Methods: A descriptive study was conducted based on data from a CSF reference service, located in São Paulo, Brazil, on 202 individuals who had enterovirus meningitis. Data was analysed by the Shapiro-Wilk and Kruskal-Wallis tests (CI = 95%, p < 0.05) and represented by the median and percentile 25 and 75, respectively. Results: The cytological and biochemical parameters of the CSF shows us that proteins had median concentrations of 33.0mg/ dL, glucose of 57.0mg/dl, lactate of 19.0mg/dL and the leukocyte of 119.0 cells/mm 3 , with a predominance of lymphocytes (42%). It was found that age can cause cytological and biochemical changes in the parameters of CSF. Children younger than 2 years had a range percentage of neutrophils and monocytes different then children aged < 2 and < 6 years, and aged < 6 and < 10 years. The protein concentration range in CSF as well as glucose track can also change according to age. Conclusion:The parameters of the CSF in patients with enteroviral meningitis showed similar median concentrations to those found in the literature. Age may lead to changes in cytological and biochemical parameters of CSF. CSF protein and glucose concentrations also change according to age.

Section: Discussionsupporting

confidence: 89%

Laboratory Parameters of Cerebrospinal Fluid in Individuals With Enterovirus Meningitis: A Descriptive Study

Wajnsztejn

et al. 2015

J. Hum. Growth Dev.

“…Recent data from the USA indicate that the peak season for HPeV detection was in the summer months [ 12 ]. The highly variable epidemiology of HPeV is supported by recent findings from South Korea, where the majority of cases were detected in spring in one study and in summer in another study [ 14 , 15 ]. However, both studies covered only a short period of time.…”

Section: Discussionmentioning

confidence: 52%

Prevalence, type and concentration of human enterovirus and parechovirus in cerebrospinal fluid samples of pediatric patients over a 10-year period: a retrospective study

Vollbach

Müller

Drexler

et al. 2015

Virol J

BackgroundHuman enterovirus (EV) and parechovirus (HPeV) are significant causes of encephalitis and meningitis in children. The aim of this study was to determine the prevalence, type and viral RNA concentration of EV and HPeV in cerebrospinal fluid (CSF) samples in an unselected cohort of patients <18 years admitted to Bonn university hospital from 1998 to 2008.MethodsA total of 327 CSF samples from 327 patients were retrospectively tested by real-time reverse-transcriptase PCR (RT-PCR) for EV and HPeV, and by real-time PCR for cytomegalovirus (CMV), herpes simplex virus 1/2 (HSV), and varizella zoster-virus (VZV). Samples had been submitted for routine virological work-up due to suspected meningitis or encephalitis and had been stored at −20 °C hereafter. Positive samples for EV and HPeV were sequenced within the gene encoding the VP1 region (EV), the VP2 and the VP3/VP1 junction region (HPeV).ResultsThe overall prevalence was 4.3 % (14/327) for EV, 0.6 % (2/327) for HPeV, and 0.3 % (1/327) for HSV and VZV, respectively. CMV was not detected in this cohort. In children less than 3 months of age the prevalence was 7.7 % (2/26) for EV and 7.7 % (2/26) for HPeV, respectively. Frequency of EV detection ranged from 0 to 12 % per year and highest rates were observed from June to September. All typed EV belonged to species B. Both HPeV infections were detected in the fall of 2008 and were typed as HPeV genotype 3. Viral RNA concentrations were highest in patients with HPeV infection, followed by echovirus 30 and other EV. In total, 86 % (12/14) of EV infections presented as aseptic meningitis, whereas both HPeV infections presented as severe sepsis-like illness.ConclusionsEV and HPeV were equally prevalent in children <3 months of age. Beyond the detection of EV and HPeV, the determination of viral RNA concentration and typing of EV and HPeV might prove beneficial for patient management and public health.

The Lancet Infectious Diseases

“…The costs of sensitive multiplex PCR assays continue to decline and results can be obtained within hours of receiving the sample in most diagnostic laboratories (68,81,82). It should be emphasised that there are multiple data which highlight that HPeV is routinely detected in CSF in the absence of pleocytosis (8,13,30,69,(83)(84)(85). CSF samples should therefore be routinely tested for HPeV in infants aged under 6 months (where the clinical burden is highest) during an acute illness irrespective of CSF white cell count.…”

Section: Improving Diagnosis Of Parechovirus Infectionsmentioning

confidence: 99%

Strategies to improve detection and management of human parechovirus infection in young infants

Kadambari

Harvala

Simmonds

et al. 2019

Human parechovirus (HPeV) infections are the second most common cause of viral meningitis in children. HPeV's are most frequently seen in infants less than 90 days of age. Clinical manifestations include encephalitis, meningitis, myocarditis and sepsis syndrome, which can lead to significant neurodevelopmental sequelae in young infants. Molecular techniques, including polymerase chain reaction assays are the diagnostic tool of choice and have contributed to a marked increase in reported cases, along with an increasing awareness of the aetiological role of HPeV in infant disease. However, focused clinical and diagnostic investigations for HPeV in infants and the use of such information in management is variable due in part to the lack of robust incidence data and its range of clinical presentations. A better understanding of the pathogenesis and epidemiology of HPeV infections is required to inform an evidence-based approach to diagnosis and treatment in the future.