Among infants with enterovirus central nervous system infection, 41% presented with a normal cerebrospinal fluid white blood cell count.
Cohort (n=78)
No
Enterovirus CNS infection in infants frequently presents without CSF pleocytosis, highlighting the need for EV testing in febrile infants regardless of CSF parameters.
BACKGROUND: Human nonpolio enterovirus (EV) is a major cause of infection in neonates and infants; however, the clinical presentation and cerebrospinal fluid findings vary significantly. Infection caused by EV in patients under 1 year of age can present with a broad clinical spectrum, from fever to severe systemic and/or neurological disease. METHODS: Retrospective cohort analysis of infants with EV central nervous system (CNS) infection presenting to a tertiary center between January 2017 and December 2022. We recorded patient demographics, parent-reported symptoms at presentation, and blood and cerebrospinal fluid (CSF) testing at presentation. RESULTS: Seventy-eight patients were included in the final study. Forty-one percent of infants with an EV CNS infection had a normal CSF white blood cell count. Clinical presentation was similar in infants with and without CSF pleocytosis. Median C-reactive protein was higher in cases of EV CNS infection without pleocytosis. CONCLUSION: EV CNS infection commonly presents without CSF pleocytosis. Testing for EV should be considered in febrile infants with no source regardless of CSF parameters.
Giva et al. (Thu,) conducted a cohort in Enterovirus central nervous system infection (n=78). Enterovirus central nervous system infection was evaluated on Normal cerebrospinal fluid white blood cell count. Among infants with enterovirus central nervous system infection, 41% presented with a normal cerebrospinal fluid white blood cell count.