Improving the diagnosis of meningitis due to enterovirus and herpes simplex virus I and II in a tertiary care hospital

Eduardo Casaroto; Alexandre R Marra; Fernando Morgadinho S Coelho; Joao Renato Rebello Pinho; Roberta Sitnik; Fernando Colombari; Elivane Silva Victor; Nair Hideko Muto; Carlos Senne; Oscar Fernando Pavão dos Santos; Michael B Edmond

doi:10.1186/1471-2334-13-487

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Improving the diagnosis of meningitis due to enterovirus and herpes simplex virus I and II in a tertiary care hospital

Journal article

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Improving the diagnosis of meningitis due to enterovirus and herpes simplex virus I and II in a tertiary care hospital

Eduardo Casaroto, Alexandre R Marra, Fernando Morgadinho S Coelho, Joao Renato Rebello Pinho, Roberta Sitnik, Fernando Colombari, Elivane Silva Victor, Nair Hideko Muto, Carlos Senne, Oscar Fernando Pavão dos Santos, …

BMC infectious diseases, Vol.13(1), 487

10/21/2013

DOI: 10.1186/1471-2334-13-487

PMCID: PMC3853767

PMID: 24138798

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Abstract

Enterovirus and herpes simplex viruses are common causes of lymphocytic meningitis. The purpose of this study was to analyse the impact of the use molecular testing for Enteroviruses and Herpes simplex viruses I and II in all suspected cases of viral meningitis. From November 18, 2008 to November 17, 2009 (phase II, intervention), all patients admitted with suspected viral meningitis (with pleocytosis) had a CSF sample tested using a nucleic acid amplification test (NAAT). Data collected during this period were compared to those from the previous one-year period, i.e. November 18, 2007 to November 17, 2008 (phase I, observational), when such tests were available but not routinely used. In total, 2,536 CSF samples were assessed, of which 1,264 were from phase I, and 1,272 from phase II. Of this total, a NAAT for Enterovirus was ordered in 123 cases during phase I (9.7% of the total phase I sample) and in 221 cases in phase II (17.4% of the total phase II sample). From these, Enterovirus was confirmed in 35 (28.5%, 35/123) patients during phase I and 71 (32.1%, 71/221) patients during phase II (p = 0.107). The rate of diagnosis of meningitis by HSV I and II did not differ between the groups (13 patients, 6.5% in phase I and 13, 4.7% in phase II) (p = 1.0), from 200 cases in phase I and 274 cases in phase II. The number of cases diagnosed with enteroviral meningitis increased during the course of this study, leading us to believe that the strategy of performing NAAT for Enterovirus on every CSF sample with pleocytosis is fully justified.

Enterovirus Infections - diagnosis

Herpes Simplex - diagnosis

Meningitis, Viral - diagnosis

Meningitis, Viral - virology

Humans

Child, Preschool

Infant

Male

Enterovirus - isolation & purification

Hospitalization

Tertiary Healthcare

Young Adult

Herpes Simplex - virology

Enterovirus Infections - virology

Simplexvirus - isolation & purification

Adolescent

Adult

Female

Child

Details

Title: Subtitle: Improving the diagnosis of meningitis due to enterovirus and herpes simplex virus I and II in a tertiary care hospital
Creators: Eduardo Casaroto
Alexandre R Marra - Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil. alexandre.marra@einstein.br
Fernando Morgadinho S Coelho
Joao Renato Rebello Pinho
Roberta Sitnik
Fernando Colombari
Elivane Silva Victor
Nair Hideko Muto
Carlos Senne
Oscar Fernando Pavão dos Santos
Michael B Edmond
Resource Type: Journal article
Publication Details: BMC infectious diseases, Vol.13(1), 487
DOI: 10.1186/1471-2334-13-487
PMID: 24138798
PMCID: PMC3853767
NLM abbreviation: BMC Infect Dis
ISSN: 1471-2334
eISSN: 1471-2334
Publisher: England
Grant note: Intramural NIH HHS
Language: English
Date published: 10/21/2013
Academic Unit: Internal Medicine
Record Identifier: 9983905643702771

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