Analysis on pathogeny and clinical of encephalitis and meningitis syndrome in children / 中华实用儿科临床杂志

ABSTRACT

Objective To understand the clinical features and pathogenic spectrum of encephalitis and menin﹣gitis syndrome in children. Methods A total of 667 cases of children with encephalitis or meningitis diagnosed and documented at Changchun Children′s Hospital from May 2012 to July 2015 were enrolled. A variety of samples in diffe﹣rent types were collected and presented,including 335 cerebrospinal fluid specimens,530 blood samples,and 332 stool samples. All the samples were collected from the patients within 72 hours on admission. Moreover,these samples are analyzed and tested,including PCR for enterovirus(EV),herpesvirus(HSV),mycobacterium tuberculosis( TB)and My﹣coplasma pneumoniae(MP)nucleic acid in cerebrospinal fluid samples;fecal specimens were tested for EV,enterovirus 71(EV71),coxsackievirus A6(CA6),coxsackievirus A16(CVA16),coxsackievirus A10( CVA10)nucleic acids;degenerate primers to amplify Echovirus 30(Echo30). Clinical data of children were collected. Results The peak in﹣cidence of encephalitis and meningitis syndrome was from June to August,age distribution was from 0 to 15 years old, the proportion of children aged from 0－6 accounted for 81. 41﹪;the highest proportion was among 0－1 years old in﹣fants,occupying 32. 38﹪;408 males and 259 females;the main symptoms were fever(586 cases),apathy(337 ca﹣ses),vomiting(307 cases)and headache(203 cases). And clinical signs included drowsiness(103 cases),neck stiff﹣ness(71 cases),meningeal irritation(12 cases),and pathological reflex( 313 cases),etc. The clinical diagnosis included 272 cases of viral encephalitis,332 cases of severe hand,foot and mouth disease complicated by encephalitis, 30 cases of bacterial meningitis,and 33 other cases;the etiological detection included:the positive rates of EV,EBV and Echo30 in cerebrospinal fluid specimens were 59. 72﹪,3. 16﹪ and 70. 00﹪,respectively. And EV71,CVA16,CVA6, EV71+CA16 and EV71+CVA16+CVA6 nucleic acids were detected in fecal samples,in which the highest detection rate was EV71(98. 96﹪). Conclusions In Changchun Children′s Hospital,the children with encephalitis and menin﹣gitis are mainly viral encephalitis. The main symptoms were fever,apathetic,drowsiness,vomiting and headache. Signs included,neck stiffness,meningeal irritation,and pathological reflexes,etc. The main pathogen of the disease is EV71.