title: [Aseptic meningitis syndrome due to enterovirus and Leptospira sp in children of Salvador, Bahia].
abstract: For the purpose of identifying the frequency that enterovirus, leptospires, arbovirus cause aseptic meningitis syndrome (AMS) during non-epidemic periods and comparing patients with and without laboratory evidence for an etiologic agent, 112 patients were selected aged between 3 months and 15 years and a clinical suspicion of AMS and were referred to Couto Maia Hospital, the Infectious and Parasitic Disease Reference Center for Salvador, Bahia. In 44.6% (n=50), the etiologic agent for the diagnosis was laboratory-confirmed: enterovirus was identified in 37.7% (n=42) of the cases by the PCR Amplicor diagnostic kit, cerebrospinal fluid or fecal culture isolation; Leptospira sp. in 7.12% (n=8) by the microagglutination test; and arbovirus in non of the cases by inhibition of passive hemagglutination. In 14 of the 22 enteroviral isolates that were evaluated, 6 different serotypes were identified with Echovirus-4 being the major serotype (27.2%; 6/22) among all found (Coxsackie B2, B3, B6 and B9; Enterovirus 71). In conclusion, enteroviruses were the most frequent etiologic agent of AMS and that leptospirosis should be included in the differential diagnosis. In addition, patients with and without laboratory-confirmed identification of the etiologic agent had similar demographic and clinical characteristics and cerebrospinal fluid findings (p >0.05), therefore suggesting that patients without a confirmed diagnosis had enteroviral or leptospiral etiologies.
authors.affiliation: Departamento de Pediatria, Faculdade de Medicina, Universidade Federal da Bahia, Brasil. hagars@ufba.br
authors.forename: Hagamenon R
authors.initials: HR
authors.lastname: Silva
authors.forename: Gustavo Mustafa
authors.initials: GM
authors.lastname: Tanajura
authors.forename: José
authors.initials: J
authors.lastname: Tavares-Neto
authors.forename: Maria de Lourdes C
authors.initials: Mde L
authors.lastname: Gomes Md
authors.forename: Alexandre da Costa
authors.initials: Ada C
authors.lastname: Linhares Ad
authors.forename: Pedro F C
authors.initials: PF
authors.lastname: Vasconcelos
authors.forename: Albert Icksang
authors.initials: AI
authors.lastname: Ko
mesh_terms: D000293:Adolescent; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007922:Leptospirosis; D008297:Male; D008582:Meningitis, Aseptic / Q000175:diagnosis / Q000382:microbiology*