[Enteroviral meningitis. Clinical and laboratory findings in a series of 60 children].

OBJECTIVE

To describe the epidemiologic, clinical and laboratory findings in a series of children with enteroviral meningitis.

PATIENTS AND

METHODS

We performed a retrospective descriptive study of all the children admitted to our hospital between May 1996 and September 1997 with a diagnosis of enteroviral meningitis, defined as either a positive cerebrospinal fluid (CSF) culture for enterovirus or pleocytosis in conjunction with a positive enterovirus culture at any other site (rectal or pharyngeal swabs).

RESULTS

Sixty cases of enteroviral meningitis were found, all of which occurred between May and July. The median age was 6 years. Half the patients were diagnosed in the first 6 hours of illness and 20 % in the first 2 hours. The most frequent symptoms were headache (97 %) and vomiting (80 %). Fever was present in only 56 % of the patients. On physical examination 78 % presented positive meningeal signs. A total white blood cell count of more than 15,000/l was present in 28 %. CSF white cell count was over 500/l in only five patients and in four pleocytosis was absent; a predominance of polymorphonuclear cells was found in 45 %. Enterovirus was isolated 43 % of the CSF specimens. The median length of hospital stay was 2 days. Antibiotic treatment was started in 13 % of the patients and all recovered without sequelae.

CONCLUSIONS

All the cases occurred in late spring. Fever was an inconstant finding. Laboratory findings were typical of viral meningitis, although the percentage of neutrophils in CSF varied widely, with more than 50 % of neutrophils in half of the patients; the absence of pleocytosis was not unusual. The enterovirus yield from the CSF specimens was higher than in previously reported in Spanish series but did not influence the management of our patients.