An Outbreak of Mumps Meningitis Among Adolescents / 대한소아신경학회지

PURPOSE: We report sharp rise of incidence of mumps meningitis at our institute and describe the clinical manifestations, laboratory findings, and complications. METHODS: This is a retrospective study involving 34 patients with mumps meningitis at Eulji University Hospital from July 2012 to June 2014. They were diagnosed by definite parotid gland swelling and leukocytosis in cerebrospinal fluid (CSF) study. RESULTS: Nineteen (55.9%) of the 34 patients with mumps meningitis were confirmed as positive by the mumps virus-specific immunoglobulin M (IgM) antibody in serum or CSF and the remaining 15 patients (44.1%) were classified as probable cases. We identified 31 boys and 3 girls clearly showing male predominance. The median age of the patients was 15.8 years and all patients were in the middle school and high school age group. Sixteen patients (47.1%) had unilateral mumps and 29 patients (85.3%) were diagnosed with meningitis after parotid swelling. Six patients (17.6%) were accompanied by testicular involvement and one (2.9%) showed hearing loss. The positivity of mumps virus specific IgM was 17 of 34 (50.0%) in serum and 4 of 34 (11.8%) in CSF. The total duration of illness including hospitalization was 5 to 21 days, median being 11 days. There was no serious neurologic deficit but 5 of 34 (14.7%) complained dizziness after discharge. It caused delay in back-to-work. CONCLUSION: It is worthy to notice that recent outbreak of mumps among adolescents are more complicated. We need to be more aggressive about prevention of mumps outbreak which bring on substantial socioeconomic loss.

A Clinical Study of Pediatric Bacterial Meningitis in Daejeon and Chungcheong area : 2006-2010 / 대한소아신경학회지

PURPOSE: The aim of this study was to investigate the causative organisms, clinical manifestations, and prognosis of pediatric patients with bacterial meningitis in Daejeon and Chungcheong area, occurred from 2006 to 2010. METHODS: We retrospectively reviewed medical records of patients aged between 1 month and 15 years, diagnosed with bacterial meningitis at 8 university or general hospitals in Daejeon and Chungcheong area. The bacterial meningitis was defined by isolation of organism from cerebrospinal fluid(CSF). The data was collected from January 2006 to December 2010, and analyzed including patient's demographics, causative organisms, clinical presentation, laboratory findings and complications. RESULTS: During the 5-year study period, 24 patients were diagnosed with CSF culture-proven bacterial meningitis. The most common causative organism was Streptococcus pneumoniae (S. pneumoniae, 37.5%), and the others were group B streptococcus (GBS, 20.8%), Escherichia coli (E. coli, 16.7%), Neisseria meningitidis (N. meningitidis, 8.3%), Haemophilus influenzae (H. influenzae, 4.2%), respectively. They initially complained of fever (95.8%), vomiting (83.3%), anorexia (45.8%), seizure (29.2%), headache (20.8%). The leukocyte counts exceeding 1,000/mm3 in CSF was observed in 14 patients (58.3%). In 15 patients (62.5%), the glucose concentration in CSF was less than 50 mg/dL, 18 patients showed that the protein concentration in CSF was more than 100 mg/dL. Long-term neurologic sequelae were observed in 4 patients (16.7%) and described as hearing disturbance (2 patients), hemiparesis (1 patient) and endocrine dysfunction (1 patient). Ten patients (41.7%) showed abnormal neuroradiologic findings and the most common abnormalities was subdural effusion (25.0%). CONCLUSION: Compared to the previous study performed between 2001 and 2005, S. pneumonia continued to be the leading cause of the pediatric bacterial meningitis in Daejeon and Chungcheong area. The frequency of pneumococcal meningitis was not decreased, despite of the introduction of conjugated pneumococcal vaccination. On the other hand, H. influenzae meningitis was notably decreased.