Clinical and analytical characteristics and short-term evolution of enteroviral meningitis in young infants presenting with fever without source.
OBJECTIVE
The objective of this study was to describe the characteristics of the enteroviral meningitis diagnosed in a pediatric emergency department among infants younger than 3 months with fever without source and its short-term evolution.


METHODS
This was a retrospective, cross-sectional, 6-year descriptive study including all infants younger than 3 months who presented with fever without source and who were diagnosed with enteroviral meningitis.


RESULTS
A lumbar puncture was practiced at their first emergency visit in 398 (29.5%) of 1348 infants, and 65 (4.8%) were diagnosed with enteroviral meningitis, 33 of them (50.7%) between May and July. Among these 65 infants, 61 were classified as well-appearing; parents referred irritability in 16 (25.3%) of them (without statistical significance when compared with infants without meningitis). Forty-one (63.0%) had no altered infectious parameters (white blood cell [WBC] count between 5000 and 15,000/μL, absolute neutrophil count less than 10,000/μL, and C-reactive protein less than 20 g/L), and 39 (60%) had no pleocytosis. All of the 65 infants recovered well, and none of them developed short-term complications.


CONCLUSIONS
The symptoms in infants younger than 3 months with enteroviral meningitis were similar to those in infants with a self-limited febrile process without intracranial infection. C-reactive protein and WBC count were not good enteroviral meningitis predictors. Cerebrospinal fluid WBC count was normal in many of these infants, so performing a viral test is recommended for febrile infants younger than 3 months in which a lumbar puncture is practiced during warm months. The short-term evolution was benign.
Pediatric Emergency Department, Cruces Hospital, Barakaldo, Spain. borja.gomezcortes@osakidetza.net
Borja
B
Gomez
Santiago
S
Mintegi
Mari Cruz
MC
Rubio
Diego
D
Garcia
Silvia
S
Garcia
Javier
J
Benito
D003430:Cross-Sectional Studies; D004630:Emergencies; D004769:Enterovirus Infections / Q000150:complications* / Q000175:diagnosis; D005335:Fever of Unknown Origin / Q000821:virology*; D006403:Hematologic Tests; D006801:Humans; D007223:Infant; D007508:Irritable Mood; D008587:Meningitis, Viral / Q000150:complications* / Q000175:diagnosis; D058889:Molecular Typing; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013030:Spain; D013129:Spinal Puncture; D014776:Virus Cultivation