Patologìâ (Apr 2014)

MODERN CLINICAL AND LABORATORY FEATURES OF ENTEROVIRAL MENINGITIS

  • O. V. Usacheva,
  • K. S. Mironova,
  • O. M. Firyulina,
  • V. K. Syvolap

DOI
https://doi.org/10.14739/2310-1237.2014.1.25161
Journal volume & issue
no. 1
pp. 76 – 79

Abstract

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Among numerous viral meningitises from 80% to 90% of cases are accounted for meningitis of enteroviral etiology according to the international data. Despite the favorable disease course, there are forms which are characterized by severe damage of CNS. In order to improve diagnostics of enteroviral meningitis in this article we have made a comparative analysis of clinical and laboratory parameters in 23 patients with enteroviral meningitis and 18 patients with serous meningitis of non-enteroviral etiology. Anamnesis data and the major clinical manifestations of the disease dynamics were analyzed. Particular attention is paid to the comparison of diagnoses, by which patients were sent to infectious hospital, the symptoms that occurred during patients’ admission into hospitals and their severity. The presence and severity of meningeal symptoms and the indices of cerebrospinal fluid in the patients of the comparison group were analyzed in detail. It is shown that enteroviruses are the important factor in the development of meningitis in the children of younger age. The clinical picture of enteroviral meningitis often develops gradually for 2-3 days and includes the typical syndromes: intoxication and meningeal ones. Every third patient with enterovirus infection has diarrhea and catarrhal symptoms, that’s why it is difficult to diagnose meningitis in its early stages, but it allows to assume enteroviral etiology of the disease. The meningitis of enteroviral etiology is characterized by multiple meningeal signs, while the non-enteroviral meningitis is characterized by dissociation with the prevalence of the of Kernig’s and Brudzinski’s symptoms. The analysis of the laboratory data showed that the enteroviral meningitis is characterized by low (over 50-100 cells) "mixed" pleocytosis (the ratio of lymphocytes and neutrophils is about 1:1). These data can be used for differential diagnosis between enteroviral meningitis and serous meningitis of non-enteroviral etiology.

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