Aetiology and cerebrospinal fluid findings in aseptic meningitis
Abstract number: P1216
Vanaga I., Broduza A., Rozentale B.
Objectives: Assessment of the etiology and cerebrospinal fluid (CSF) findings in patients with aseptic meningitis (AM) and correlation between etiology, papilledema, cerebral trauma and CSF findings.
Methods: 222 medical records of patients with AM, treated at the Infectology Center of Latvia during 2001 to 2008, were analyzed. Patients with HIV, tuberculous and tick-borne encephalitis virus meningitis were excluded. The etiology was confirmed if a microbe or microbe-specific nucleic acid was detected in the CSF or specific IgM antibodies were detected in the blood. We analyzed CSF pleocytosis, neutrophils/lymphocytes (Neu/Ly) ratio, and protein level.
Results: 222 cases of AM were reviewed. The patients ranged in age from 15 to 82. The male/female ratio was 135/87. Etiology was defined in 33%. The most common causative agents were enteroviruses 44, herpesviruses 17, B. burgdorferi 6, mumps viruses 5.
The patients with mumps meningitis had highest total pleocytosis in CSF (774.2±598.0 cells/mm3), but the lowest was in meningitis caused by B. burgdorferi (214.8±201.9 cells/mm3). 14% of all AM cases had Neu predominance. Ly count was higher in cases of mumps (754.6±592.1 cells/mm3) and herpesviruses (632.1±406.1 cells/mm3) than enterovirus (339.8±416.2 cells/mm3) meningitis, respectively, p = 0.049, p = 0.012. In 27% cases of enterovirus meningitis Neu predominance was observed.
The highest CSF protein concentration were in patients with B. burgdorferi caused meningitis (1.13±1.26 g/l), but the lowest were in patients with mumps meningitis (0.57±006 g/l). In cases with herpesviruses meningitis CSF protein level (0.95±0.39 g/l) was higher than enterovirus meningitis (0.63±0.43 g/l), respectively, p = 0.005.
The greatest part of B. burgdorferi caused meningitis patients had papilledema. None patients with mumps meningitis had papilledema. Papilledema and anamnestic head trauma didn't affected CSF pleocytosis, Neu/Ly ratio, and protein level.
Conclusion: 67% of AM the etiology remains undefined. The leading cause was enterovirus. The highest pleocytosis in CSF had patients with mumps meningitis. AM patients CSF was not characterised only as lymphocytar, in some cases, especially enterovirus meningitis, Neu predominate. B. burgdorferi meningitis CSF protein level was highest. Papilledema was more often in AM caused by B. burgdorferi.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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