Key result
Absence of CSF pleocytosis in children with enteroviral meningitis was significantly associated with being under two years of age (aOR 3.015) compared to those with pleocytosis.
Observational (n=300)
No
Odds Ratio: 3.015 (95% CI 1.598–5.689)
Absolute Event Rate: 39.7% vs 14.5%
p-value: p=<0.001
Absence of CSF pleocytosis is common in children with enteroviral meningitis, particularly in those under 2 years of age, indicating that normal CSF cell counts cannot exclude meningitis and rapid RT-PCR testing is necessary.
Normal CSF counts may not exclude enteroviral meningitis in children under 2; hypothesis-generating for age-specific thresholds and RT-PCR testing.
Clinical Characteristics of Enteroviral Meningitis with out Cerebrospinal Fluid Pleocytosis in ChildrenPurpose: The purpose of this study was to investigate the clinical features and laboratory findings of enteroviral meningitis according to the presence of cerebrospinal fluid (CSF) pleocytosis, and to investigate the factors influencing pleocytosis in children.Methods: A retrospective study was conducted in 300 children with enteroviral meningitis confirmed by CSF reverse transcriptase polymerase chain reaction (RT-PCR) between 2012 and 2016.Electronic medical records including clinical and laboratory data were assessed.Clinical factors were compared between patients with and without pleocytosis.Results: Of the total 300 children with enteroviral meningitis, 73 had no pleocytosis.The proportion of infants under the age of two years was higher in patients without pleocytosis than in patients with pleocytosis (39.7% vs 14.5%, P<0.001).Patients without pleocytosis were younger (43.4 months vs 66.2 months, P<0.001), had less prevalence of headache and vomiting, lower peripheral white blood cell count (9,740±3,555/mm 3 vs 11,632±3,872/mm 3 ) and a shorter interval between the onset and lumbar puncture than those with pleocytosis.In multiple regression analysis, younger age, vomiting, lower white blood cell count, and interval less than 24 hours from onset to spinal tap were associated with the absence of pleocytosis.Conclusion: This study showed that children younger than two years of age had high proportion of absence of pleocytosis and some of the factors analyzed correlated with CSF inflammation.Therefore, absence of pleocytosis in the initial CSF sample cannot exclude meningitis, and rapid RT-PCR testing should be performed with high suspicion in young infants.
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김나리 et al. (2017) conducted an observational in Enteroviral meningitis (n=300). Absence of CSF pleocytosis vs. Presence of CSF pleocytosis was evaluated on Proportion of patients under 2 years of age (aOR 3.015, 95% CI 1.598-5.689, p=<0.001). Absence of CSF pleocytosis in children with enteroviral meningitis was significantly associated with being under two years of age (aOR 3.015) compared to those with pleocytosis.
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