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Clinical and Virologic Study of Aseptic Meningitis

Korean Journal of Pediatrics 2004;47(4):392-398.
Published online April 15, 2004.
Clinical and Virologic Study of Aseptic Meningitis
Hyun Ji Kim1, Hae Kwan Cheong2, Cheoll Jung2, Kyu Man Lee3, Young Mee Jee4, Won Duck Kim1, Dong Seok Lee1, Doo Kwun Kim1, Sung Min Choi1
1Department of Pediatrics, College of Medicine, Dongguk University, Gyeongju, Korea
2Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju, Korea
3Department of Clinical Pathology, College of Medicine, Hallym University, Seoul, Korea
4Laboratory of Enteroviruses, Department of Virology , National Institute of Health, Korea
소아 무균성 뇌막염의 임상적 고찰
김현지1, 정해관2, 정철2, 이규만3, 지영미4, 김원덕1, 이동석1, 김두권1, 최성민1
1동국대학교 의과대학 소아과학교실
2동국대학교 의과대학 예방의학교실
3한림대학교 의과대학 진단검사의학교실
4국립보건원 바이러스질환부 소화기바이러스과
Abstract
Purpose
: The cause of aseptic meningitis remains mostly unknown because viral culture and identification is difficult. Thus, we report a study on 123 children with aseptic meningitis in Gyeongju in 2002 to identify the causing virus and the relationship with the clinical manifestation.
Methods
: We prospectively investigated the patients, admitted to Dongguk University Hospital, into two groups between April and October 2002. Group 1 included 123 patients diagnosed as aseptic meningitis. Group 2, the adimssion control, included 120 patients, who suffered from none-enteroviral diseases. Specimens of CSF and stool were collected to perform reverse transcription polymerase chain reaction(RT-PCR), and enteroviral culuture was done in RT-PCR positive patients as well.
Results
: The male to female sex ratio was 2.2 : 1 and the mean age was 6.2?.7 years. The clinical manifestations were fever, headache and vomiting. The RT-PCR for enterovirus, performed in 58 cases of CSF in group 1, showed 5.2% positive results and negative result in viral culture. The RT- PCR for enterovirus used in stool specimens showed 89.3% and 41.1% of positive results in group 1 and group 2, respectively. Viral culture of stool specimens showed five cases of echovirus 13 and four cases of echovirus 6 in group 1, whereas three cases of echovirus 6 and one case of coxsackie B4 were detected in group 2.
Conclusion
: The etiologic viruses of the aseptic meningitis outbreak in Gyeongju in 2002 is presumed to be echovirus 13 and echovirus 6. Since echovirus 13 firstly appeared with various age distributions, the outbreak may have emerged due to a lack of acquisition of immunity to this virus.
Key Words: Aseptic meningitis, Reverse transcription polymerase chain reaction(RT-PCR), Enterovirus


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