Clinical analysis of neonatal enteroviral meningitis / 中国小儿急救医学

ABSTRACT

Objective:To analyze the clinical characteristics of neonatal enteroviral meningitis.Methods:A retrospective analysis was conducted on 87 cases with intracranical infection.The cerebrospinal fluid(CSF)samples of these neonates were collected and tested by polymerase chain reaction(PCR) for enterovirus.According to the results, the cases were divided into the positive group(55 cases) and negative group(32 cases). The clinical characteristics of the cases were collected.Results:The time in hospital of the positive group was shorter than the negative group[(9.5±5.2)d vs.(21.8±15.8)d, t=4.295, P<0.001]. The cure rates of the positive group was higher[96.4%(53/55) vs. 81.2%(26/32), χ2=3.872, P=0.049]. There was no death case in the positive group, while there were 3 death cases(9.4%, 3/32)in the negative group.In summer and autumn, the morbidity of the positive group was higher[96.4%(53/55) vs.62.5%(20/32), χ2=17.181, P<0.001]. In two groups, the most predominant clinical presentation was fever[90.9%(50/55) vs. 68.8%(22/32), χ2=6.962, P=0.008]. CSF examination results showed that white blood cells, the proportion of polymorphonuclear cell and CSF protein in the positive group were lower than those in the negative group, while the proportion of mononuclear cell and CSF glucose level in the positive group were higher( P<0.001). Blood and CSF cultures were negative in the positive group.There were 10 cases whose blood cultures and CSF cultures were positive in the negative group.Among them, there were 3 cases infected by group B streptococcus, 6 cases by E. coli, 1 case by Chryseobacterium meningosepticum.The prognoses of the CSF culture positive cases were poor.The abonormal cases detected by cerebral ultrasound, MRI and aEEG were fewer in the positive group( P<0.05). Conclusion:Enterovirus is the common pathogen of nonbacterial meningitis in summer and autumn in our region.The prognosis of enteroviral meningitis is better.Neonates with suspected clinical presentation, such as fever, should undergo PCR test to check CSF for enteroviru.