[Epidemiological and clinical features of enteroviral meningitis: a case series of 59 adult patients].
OBJECTIVE
To describe the epidemiological and clinical features of enteroviral meningitis as well as the biological profile of the cerebrospinal fluid (CSF).


METHODS
A retrospective study conducted in a single centre between 2004 and 2008. All aseptic meningitis due to Enterovirus were included.


RESULTS
Fifty-nine patients were included. The triad including fever, headache and neck stiffness was reported in 62% of patients. Twelve patients (20%) had a neutrophilic leukocytosis and 23 (39%) an elevated CRP level. Twenty-eight patients (47%) had a prominent neutrophilic reaction in the CSF and nine (15.2%) had a low glucose concentration. A presumptive anti-bacterial treatment was initiated in 47 patients (80%) for an average of 3.2 days.


CONCLUSIONS
Due to the lack of specificity of clinical features and biological manifestations of Enterovirus meningitis, the widespread use of real-time Enterovirus PCR is a priority for reducing the number of unnecessary anti-bacterial treatment. Guidelines based on clinical and biological features may be associated to help physicians in the differential diagnosis between bacterial and viral meningitides.
Méchaï
F
F
Service des maladies infectieuses et tropicales, hôpital militaire Bégin, 94163 Saint-Mandé, France. mechaifrederic@wanadoo.fr
Rivière
F
F
Roux
X
X
Mérens
A
A
Bigaillona
C
C
Ficko
C
C
Imbert
P
P
Rapp
C
C
D000293:Adolescent; D000328:Adult; D004769:Enterovirus Infections / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008587:Meningitis, Viral / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000453:epidemiology* / Q000821:virology; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult