Key result
Enteroviruses were detected in only 3% (4 of 142) of children with presumed bacterial meningitis, indicating that mixed viral-bacterial infections of the CNS are rare.
Cohort (n=142)
Mixed infections of the CNS with picornaviruses and bacteria are rare in children with presumed bacterial meningitis in Angola, and detection of an enterovirus does not appear to affect the clinical picture and outcome.
Answers are grounded in this paper and cite their sources.
Rare enterovirus co-detection in presumed bacterial meningitis supports targeted testing; hypothesis-generating for CNS co-infection epidemiology and should not yet change practice.
Human enteroviruses are the most common cause of viral meningitis. Viral-bacterial interaction may affect the clinical course and outcome of bacterial meningitis. In Africa, viruses might be responsible for 14-25% of all meningitis cases. However, only few studies from Africa have reported detection of viruses in the cerebrospinal fluid (CSF) or mixed viral-bacterial infections of the central nervous system (CNS). The aim of the present study was to investigate the presence of picornaviruses in the CSF of children suffering from meningitis in Luanda, Angola. The study included 142 consecutive children enrolled in a prospective study of bacterial meningitis in Luanda between 2005 and 2006, from whom a CSF sample was available. CSF samples were obtained at hospital admission, stored in a deep-freeze, and transported to Finland for testing by real-time PCR for picornaviruses. Enteroviruses were detected in 4 (3%) of 142 children with presumed bacterial meningitis. A 5-month-old girl with rhinovirus and Haemophilus influenzae meningitis recovered uneventfully. An 8-year-old girl with human enterovirus and pneumococcal meningitis developed no sequelae. A 2-month-old girl with human enterovirus and malaria recovered quickly. A 7-month-old girl with human enterovirus was treated for presumed tuberculous meningitis and survived with severe sequelae. Mixed infections of the CNS with picornaviruses and bacteria are rare. Detection of an enterovirus does not affect the clinical picture and outcome of bacterial meningitis.
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Pelkonen et al. (2012) conducted a cohort in presumed bacterial meningitis (n=142). Picornavirus/enterovirus infection was evaluated on Detection of enteroviruses in cerebrospinal fluid. Enteroviruses were detected in only 3% (4 of 142) of children with presumed bacterial meningitis, indicating that mixed viral-bacterial infections of the CNS are rare.
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