[Meningitis by enterovirus in pediatrics. Clinical characteristics and virologic diagnosis].

BACKGROUND AND

METHODS

With the aim of knowing the etiology of aseptic meningitis (pleocytosis in LCR with negative bacterial culture and positive or negative virus culture or without pleocytosis with viral culture in positive LCR), 48 children attending the Emergency Department of our hospital from June to December, 1995 were prospectively studied. Pharyngeal and rectal swab, LCR for bacteria and virus and blood cultures were carried out. The samples were inoculated in fibroblasts MRC-5, RD and BGM. The cytopathic effect was identified by immunofluorescence. Typing was performed in the National Center of Public Health Care Microbiology, Virology and Immunology in Majadahonda (Spain).

RESULTS

Isolation of the virus was positive in 40/48 (83.3%) of the children: in 17 (35.5%) of LCR and the remaining 23/40 (47.9%) of pharyngeal and/or rectal swab. In all the cases the cytopathic effect was detected in MRC-5. The viruses found were echovirus 30 and 5. A greater incidence of the disease was observed in November and December.

CONCLUSIONS

Meningitis by enterovirus is frequent in our area. Culture of the virus in LCR, the pharynx and stools is useful on suspicion of aseptic meningitis since the virus may be isolated from LCR in more than one third of the patients. Serotyping aids in surveilling the appearance of outbreaks and to know the predominant viruses. Cell culture is the diagnostic treatment of choice, but has a low sensitivity and is slow. The application of other techniques such as PCR which have a greater sensitivity and with high specificity for the diagnosis of these infections is necessary.