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Enterovirus meningitis in south west Greece: clinical manifestations and CSF laboratory findings

Abstract number: 1733_949

Frantzidou F., Agelatou A., Dumaidi K., Kaleyias J., Papa A., Antoniadis A., Spiliopoulou A.

Introduction: Enteroviruses are common human viruses associated with various clinical syndromes, from minor febrile illness to severe, potentially fatal conditions such as aseptic meningitis, myocarditis and neonatal enterovirus sepsis. The method of molecular identification not only provides rapid diagnosis of enterovirus infection, but also information about the genetic character of the viruses.

Objective: The aim of the study was the assessment of the enteroviral (EV) RNA detection by reverse transcription polymerase chain reaction (RT-PCR) in the diagnosis of enteroviral meningitis.

Methods: All consecutive cases of aseptic meningitis that were admitted at the Children Hospital of Patras during the study period (December 2004–June 2006) were including in the study. Clinical data were analysed. Rapid detection of EV RNA was directly carried out in the cerebrospinal fluid CSF using RT-PCR targeting to VP1–2A region and nucleotide sequence analysis.

Results: Thirty cases of aseptic meningitis were including during the study period. RT-PCR for EV RNA was positive in 12/30 (40%) of cases. The ratio male: female was 2:1. The main clinical manifestations were: fever (100%), headache (42%) nuchal rigidity (40%), skin rash (30%) and vomiting (30%). The CSF leukocyte count was elevated in all the cases and revealed a lymphocytic-monocytic predominance. The identified virus were found to be HEV-B group: 1 strain echovirus 11 (8.3%), 1 echovirus 14 (8.3%), 2 strains echovirus 9 (16.7%), 3 strains echovirus 6 (25%) and 5 new strains (41.7%) of the HEV-B species. Five cases (41.7%) were taken place at the end of October–November 2005 (HEV-B) and three cases (25%) with echovirus 6 in January.

Conclusions: The predominant strains during the study period were the new strain of the species HEV-B and echovirus 6. The new strain of the species HEV-B had prominent fall seasonality; in addition, there was a perennial distribution of EV meningitis cases. The molecular techniques (RT-PCR/VP1–2A) seem to be accurate and rapid methods for the detection and identification of enterovirus.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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