ABSTRACT
Durante el año 1993 se presentó un aumento de 3 veces el número promedio de casos de meningitis asépticas en el Hospital Roberto del Río. Se presentan las características clínicas de 50 niños mayores con meningitis aséptica, y se detallan las de 16 casos de ellos con diagnóstico comprobado de meningitis por enterovirus. El cuadro clínico fue benigno, no hubo complicaciones, muerte o secuelas al alta. Dentro de los hallazgos de laboratorio, se destaca el promedio de neutrófilos en el 30 por ciento de los casos en la punción lumbar de control,luego de 24 horas o más de evolución de la enfermedad.El echovirus 30 fue el enterovirus predominante. Se comparan los hallazgos con la literatura, y se comenta la utilidad de una segunda punción lumbar en casos como éstos
Subject(s)
Humans , Male , Female , Enterovirus Infections/physiopathology , Enterovirus/pathogenicity , Meningitis, Aseptic/physiopathology , Meningitis, Viral/physiopathology , Cerebrospinal Fluid/virologyABSTRACT
A 9 month old boy was admitted to the hospital with the diagnosis of meningoencephalitis 15 days after having a clinically diagnosed chickenpox. Lumbar puncture showed clear CSF with 0.23 g/l of proteins, 57 mg/dl of glucpse, 30 red cells/mm3 and 5 leukocytes/mm3. Blood count showed a packed red cell volume of 22 percent, a hemoglobin of 7 g/dl, 14800 leukocytes with 1 percent eosinophils, 5 percent band and 39 percent segmented neutrophils, 50 percent lymphocytes and 5 percent monocytes and a decreased platelet count. On the fourth hospitalization day, the patient had vomiting, irritability and stiff neck. A new lumbar puncture showed a clear CSF that differed from the former only on the glucose level that increased to 102 mg/dl. The patient died and the necropsy showed a congestive and enlarged brain and congestive meninges infiltrated with lymphocytes. There was lymphoid follicle hyperplasia in the small bowel and enlarged mesenteric lymph nodes. Samples of brain, brain stem, spinal cord and tools were sent for virological study. A coxsakie B-5 virus was isolated from the spinal cord sample