Clinical Features and Neurologic Complications of Pediatric Enteroviral Meningitis.

Choi,  Seo Yeol; Lee,  Young Seok; Yu,  Jeesuk

doi:2017.25.4.246

Ann Child Neurol > Volume 25(4); 2017 > Article

Original Article

Journal of the Korean Child Neurology Society 2017;25(4):246-254.
DOI: https://doi.org/10.26815/jkcns.2017.25.4.246 Published online December 30, 2017.

Clinical Features and Neurologic Complications of Pediatric Enteroviral Meningitis.

Seo Yeol Choi, Young Seok Lee, Jeesuk Yu

¹Department of Pediatrics, Dankook University College of Medicine, Cheonan, Korea. dryujs@dankook.ac.kr
²Department of Radiology, Dankook University College of Medicine, Cheonan, Korea.

Abstract

PURPOSE
To explore clinical features and neurologic complications of pediatric enteroviral meningitis, and to evaluate risk factors according to the presence of cerebrospinal fluid (CSF) pleocytosis and neurologic complications. METHODS: Retrospective review of medical records of patients aged between 1 month and 18 years who were found positive for CSF enterovirus reverse transcription polymerase chain reaction in Dankook University Hospital from March 2009 to February 2015. RESULTS: A total of 151 children was enrolled in the study. Ninety four patients were males and the age at diagnosis was 40.9±47.0 months. Most common season of admission was summer (n=99, 65.6%). Most frequent presenting symptom was fever followed by poor oral intake, decreased activity, and headache. Fifty five (36.4%) patients had no CSF pleocytosis. Complications were observed in 4 (2.6%). Mean blood white blood cell, CSF protein levels were higher, and CSF glucose levels were lower in group with pleocytosis (P < 0.05). There were more seizure development and mental changes, higher peak body temperature, longer fever duration, and longer duration from symptom onset to CSF tapping in group with complications (P < 0.05). All were boys and mean age at admission was younger in group with complications, without statistically significant difference. CONCLUSION: Relatively high proportion of children with enteroviral meningitis showed no pleocytosis. Complications such as meningoencephalitis, refractory status epilepticus, or recurrent seizure rarely occurred, although most had good clinical outcomes.

Key Words: Enterovirus, Meningitis, Pleocytosis, Complication