title: [Aseptic meningitis in pediatrics].
abstract: We analyzed the 259 pediatric patients (69% males, 31% females) treated for aseptic meningitis at the Department of Pediatrics (Inselspital), University of Berne, Switzerland, during the 10-year period from 1978 to 1987. 79% were in- and 21% outpatients. The main study purpose was the evaluation of clinical presentation, diagnostic workup, course and prognosis of this disease entity. The clinical characteristics (fever, meningitic signs, headache, nausea and vomiting, and usually normal consciousness) were not discriminative for differential diagnosis. On the other hand, pleocytosis in cerebrospinal fluid averaged 406 x 10(6) cells/l (57% mononuclear cells) at first lumbar puncture, and 6 to 12 hours later showed both slight decrease of total cell count and clear shift to mononuclear cells (71%). The course of the disease was always short and benign. Complications, usually of a neurologic nature, occurred in only 10% and all were mild and reversible. Nevertheless, follow-up interview by phone identified 21% of patients with transient post-meningitic disorders, especially prolonged episodes of stress-induced headache. However, except for one case of chronic hydrocephalus, there were no severe or persistent sequelae. Neither complications nor sequelae correlated with patient age or laboratory findings. Our results confirm that aseptic meningitis in children is relatively benign, and underline the importance of rest and relaxation during convalescence. Rapid, reliable and cheap viral diagnostic tests in the cerebrospinal fluid could simplify the management of the individual patient with regard to repeated lumbar punctures (in 36%), surveillance in the hospital (in 79%), and antibiotic therapy (in 25%).
authors.affiliation: Medizinische Universitäts-Kinderklinik, Inselspital Bern.
authors.forename: C G
authors.initials: CG
authors.lastname: Etter
authors.forename: J
authors.initials: J
authors.lastname: Wedgwood
authors.forename: U B
authors.initials: UB
authors.lastname: Schaad
mesh_terms: D000293:Adolescent; D002555:Cerebrospinal Fluid / Q000166:cytology; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008487:Medical History Taking; D008582:Meningitis, Aseptic / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D008587:Meningitis, Viral / Q000175:diagnosis; D010808:Physical Examination; D011379:Prognosis; D012189:Retrospective Studies; D013129:Spinal Puncture
vernacular_title: Aseptische Meningitiden in der Pädiatrie.