Enteroviral Meningitis and Concurrent Peripheral Motor Axonal Polyneuropathy
Division of Pediatric Infectious Diseases, Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.The Pediatric Infectious Disease Journal (Impact Factor: 2.72). 02/2012; 31(2):206-8. DOI: 10.1097/INF.0b013e31823a0d6e
Enteroviral infections can cause acute flaccid paralysis resulting from anterior myelitis, but the occurrence of axonal polyneuropathy is not well described. We report an 8-year-old boy who presented with symmetric, ascending flaccid paralysis and was diagnosed with concurrent echovirus type 9 viral meningitis.
- The Journal of pediatrics 02/2013; 162(6). DOI:10.1016/j.jpeds.2013.01.028 · 3.79 Impact Factor
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ABSTRACT: Background: Acute enterovirus (EV) meningitis is a major cause of hospitalization among adults and children. It is caused by multiple EV genotypes assigned to 4 species (EV-A, EV-B, EV-C, and EV-D). Methods: We determined viral loads in the cerebrospinal fluid (CSF) of 156 patients of all ages with EV meningitis during a 5-year observational prospective study. The virus strains were genotyped, and their time origin was determined with Bayesian phylogenetic methods. Results: The CSF viral loads ranged between 3.4 and 7.5 log10 copies/mL (median, 4.9 log10 copies/mL). They were higher in neonates than in infants and children (P = .02) but were comparable in adults. Viral loads were associated with EV genotypes (P < .001). The EV strains were identified in 152 of 156 patients and assigned to 23 genotypes within the EV-A and EV-B species. The most frequent genotypes, echoviruses 6 and 30, were associated with different viral loads (P < .001). The highest viral loads were in meningitis cases caused by coxsackievirus A9, B4, and B5 genotypes. Most patients infected by a same genotype were infected by a major virus variant of recent emergence. Conclusions: The variations in CSF viral loads in patients at the onset of EV meningitis are related to genotypic differences in the virus strains involved.The Journal of Infectious Diseases 03/2014; 210(4). DOI:10.1093/infdis/jiu178 · 6.00 Impact Factor
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