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KMID : 0391520160240010001
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Journal of the Korean Child Neurology Society
2016 Volume.24 No. 1 p.1 ~ p.7
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Clinical Characteristics of Childhood Enteroviral Meningitis according to Age and Viral Serotype
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Yang Jae-Hyuk
Song Ji-Ho
Cheon Kyeong-Ryeol
Chung Jae-Keun
Song Eun-Song
Choi Young-Youn
Woo Young-Jong
Kim Young-Ok
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Abstract
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Purpose: Enterovirus is the most common cause of aseptic meningitis, and there are
many different serotypes of enteroviruses that cause diverse clinical symptoms. This
study compared the clinical characteristics of childhood enteroviral meningitis in
different age groups and viral serotypes.
Methods: Patients younger than 18 years who were diagnosed with aseptic
meningitis in the Pediatric Department of Chonnam National University Hospital
from January 2008 to December 2014 were enrolled. We retrospectively reviewed
their clinical records.
Results: Enterovirus was tested in 66.6% of 655 patients with aseptic meningitis, with
the testing being more frequent in younger patients (P<0.001). Enterovirus was present
in 69.7% of patients, and able to be serotyped in 52.6%. Headache and irritability were
more frequent in older children, whereas respiratory and neurologic symptoms were
more common in infants and early childhood (P<0.05). Marked pleocytosis in the
cerebrospinal fluid (CSF) was more frequent in neonates and infants, whereas marked
increases in CSF proteins were more common in adolescents (P<0.05). The most common
enterovirus was coxsackievirus B1 (CB1) in neonates and enterovirus 71 (EV71) in infancy
and early childhood. Compared with the mean frequencies of symptoms in enteroviral
meningitis, less frequent symptoms were fever in echoviruses (Es), headache or irritability
in CBs and EV71, and vomiting in CBs. Neurologic symptoms were frequent in EV71
(P<0.05). Marked CSF pleocytosis was more frequent in CBs and Es (P<0.05).
Conclusion: The clinical characteristics and laboratory findings of childhood
enteroviral meningitis differ with age and viral serotype. In addition, the prevalent
enteroviral serotypes differ with age.
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KEYWORD
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Aseptic meningitis, Enterovirus, Child, Age, Serotype
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