Enteroviruse Meningoencephalitis in Children
Mohamed Mostafa Ali Elmorsy;
Abstract
SUMMARY
E
nteroviruses affect millions of people worldwide each year. Enterovirus-71 infection cause serious clinical disease and psychological disorders in young children as the brain stem is the most likely target for infection and Enteroviruses are a primary cause of aseptic meningitis and are among the more commonly detected viral causes of encephalitis.
Childhood Enterovirus encephalitis presents with fever, altered mental state (encephalopathy), a deteriorating level of consciousness, focal seizures or focal neurological abnormalities. Parents can describe encephalopathy as a change in behaviour, sleepiness or confusion. Children with normal behaviour at presentation may become confused later as the encephalitis progresses.
The present study was a cross sectional study carried out to identify Enteroviruses as a causative agents as etiology of viral meningo-encephalitis in patients attending Ain-Shams University Children Hospital with picture suggestive meningo-encephalitis hospital by using polymerase chain reaction PCR to detected Enterovirus cDNA in the CSF.
Our study was done on 50 patients with age above 6 months, presenting with altered mental status, and fever in a previously normal infant or child with normal developmental history. Any patient with electrolyte disturbance that might be implicated in altering the mental status, recent history of head trauma, receiving drugs that might affect the mental status, delayed development or those with MRI brain suggesting structural brain lesion e.g. ADEM, neurodegenerative disease, or brain tumor were excluded from this study.
For all patients full history taking, full clinical examination and (investigations CBC, ESR, CRP, liver enzyne, CSF examination including enterovirus , PCR) and neuraimaging were done.
Statistical analysis of our results showing that the mean age of enrolled patients was 3.70 ± 1.05 years ranged from 2 to 5.4 years with male predominance among enrolled patients (males (64.0%) and 18 (36.0%) females with male to female ratio: 1:1.8.
Most of enrolled patients in our study were presented with altered consciousness 49 cases (98%), while 42 cases presented with convulsion (84%), 32 cases presented with fever (64%), 31 cases presented with vomiting (62%), 11 cases presented with diarrhea (22%) and two cases were presented with headache (4.0%). Glasgow coma score (GCS) of enrolled patients 11.72 ± 1.01 ranged from 10 to 14.
CSF examination of all enrolled cases in our study (100 %) had WBC count of more than 100 cells/mm3 with all of these cells were lymphocytes. 86% of cases have mild to moderately elevated CSF protein levels and normal protein level in 14 % with normal glucose in 94% and decreased glucose level in 6 %.
E
nteroviruses affect millions of people worldwide each year. Enterovirus-71 infection cause serious clinical disease and psychological disorders in young children as the brain stem is the most likely target for infection and Enteroviruses are a primary cause of aseptic meningitis and are among the more commonly detected viral causes of encephalitis.
Childhood Enterovirus encephalitis presents with fever, altered mental state (encephalopathy), a deteriorating level of consciousness, focal seizures or focal neurological abnormalities. Parents can describe encephalopathy as a change in behaviour, sleepiness or confusion. Children with normal behaviour at presentation may become confused later as the encephalitis progresses.
The present study was a cross sectional study carried out to identify Enteroviruses as a causative agents as etiology of viral meningo-encephalitis in patients attending Ain-Shams University Children Hospital with picture suggestive meningo-encephalitis hospital by using polymerase chain reaction PCR to detected Enterovirus cDNA in the CSF.
Our study was done on 50 patients with age above 6 months, presenting with altered mental status, and fever in a previously normal infant or child with normal developmental history. Any patient with electrolyte disturbance that might be implicated in altering the mental status, recent history of head trauma, receiving drugs that might affect the mental status, delayed development or those with MRI brain suggesting structural brain lesion e.g. ADEM, neurodegenerative disease, or brain tumor were excluded from this study.
For all patients full history taking, full clinical examination and (investigations CBC, ESR, CRP, liver enzyne, CSF examination including enterovirus , PCR) and neuraimaging were done.
Statistical analysis of our results showing that the mean age of enrolled patients was 3.70 ± 1.05 years ranged from 2 to 5.4 years with male predominance among enrolled patients (males (64.0%) and 18 (36.0%) females with male to female ratio: 1:1.8.
Most of enrolled patients in our study were presented with altered consciousness 49 cases (98%), while 42 cases presented with convulsion (84%), 32 cases presented with fever (64%), 31 cases presented with vomiting (62%), 11 cases presented with diarrhea (22%) and two cases were presented with headache (4.0%). Glasgow coma score (GCS) of enrolled patients 11.72 ± 1.01 ranged from 10 to 14.
CSF examination of all enrolled cases in our study (100 %) had WBC count of more than 100 cells/mm3 with all of these cells were lymphocytes. 86% of cases have mild to moderately elevated CSF protein levels and normal protein level in 14 % with normal glucose in 94% and decreased glucose level in 6 %.
Other data
| Title | Enteroviruse Meningoencephalitis in Children | Other Titles | التهاب السحايا و الدماغ الفيروسى فى الأطفال الناتج عن الفيروس المعوى | Authors | Mohamed Mostafa Ali Elmorsy | Issue Date | 2017 |
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