No abstract available.
Meningitis* ; Meningitis, Viral*

To evaluate the diagnostic value of lactate dehydrogenase (LDH) in bacterial meningitis (BM) and viral meningitis (VM), LDH was determined simultaneously in cerebrospinal fluid (CSF) and in sera of 89 children suffering from meningitis (51 BM and 38 VM) by 3 time (acute phase, 7-10 days later, and recovering period). Control group consists of 33 normal children. In blood, LDH activity was always elevated, statistically different from control group (p<0.05) but these was no difference between BM and VM. So LDH in sera isn't helpful in the differential diagnosis between BM and VM. In contrast, LDH activity in CSF was highly statistical difference from control group (p<0.001) and there was statistical different between BM and VM. Therefore, LDH activity in CSE has great value in the differential diagnosis between BM and VM; it possesses prognostic value in BM.
Meningitis ; cerebrospinal fluid ; blood ; Meningitis, Bacterial ; Meningitis, Viral

No abstract available.
Clonidine ; Horner Syndrome ; Meningitis, Viral

Viral meningitis is an infected central nervous system, common in children. There are many causes of disease with different incidences depended on the climate, geographical position. The most causes are Enterovirus, Arborvirus... Diagnosis is based on epidemiological, clinical, and paraclinical factors. There isn't specific treatment, only managements of symptoms, so preventive methods such as immune prevention, isolation... are very important
Meningitis, Viral ; Nervous System ; child

We report herein a case of meningitis due to Streptococcus viridans that occurred after epidural nerve block. The low virulence of S. viridans resulted in milder clinical symptoms and signs than are usually observed for bacterial meningitis, thus mimicking viral meningitis. The infection may have originated from the oral cavity of the medical personnel, and so S. viridans infection should be included in the differential diagnosis of meningitis subsequent to spinal manipulation.
Diagnosis, Differential ; Manipulation, Spinal ; Meningitis ; Meningitis, Bacterial ; Meningitis, Viral ; Mouth ; Nerve Block ; Streptococcus ; Viridans Streptococci

BACKGROUND: The enteroviruses are the most common etiologic agent of aseptic meningitis in adults and children. The incidence of enteroviral meningitis in childhood meningitis is up to 80%, but in adults is not known, worldwidely. In Korea, where tuberculosis is endemic, the rapid and accurate diagnostic method for enteroviral meningitis is required especially because early differential diagnosis of viral meningitis from tuberculous meningitis is very important. The aims of this study were the demonstration of enteroviruses from cerebrospinal fluid (CSF) of adult patients with aseptic meningitis by PCR/Southern hybridization and the verification of the usefulness of PCR/southern hybridization as a rapid diagnostic tool. METHODS: From July 1992 to June 1995, total 34 CSF samples (10 from children, 24 from adults) of patients with aseptic meningitis were studied. As a control group, 15 patients with tuberculous meningitis and 15 patients with bacterial meningitis were studied. Viral RNA was extracted from CSF, reverse transcriptied into cDNA and amplified. The PCR products were Southern hybridizied with enteroviruses-specific digoxigenin-labelled probe. RESULTS: 16/24(66.7%) samples of adult patients with aseptic meningitis were positive for enteroviruses, while in child patients with aseptic meningitis, 9/10(90%) samples were positive. And in one patient, PCR was positive from asymptomatic, onset-7th day CSF sample. CONCLUSION: Enteroviruses were the most common causative organisms of adult aseptic meningitis in Korea. And, this study showed the usefulness of PCR/Southern hybridization of enteroviruses from CSF for etiologic diagnosis of adult aseptic meningitis in subclinical, asymptomatic period.
Adult* ; Cerebrospinal Fluid* ; Child ; Diagnosis ; Diagnosis, Differential ; DNA, Complementary ; Enterovirus* ; Humans ; Incidence ; Korea ; Meningitis ; Meningitis, Aseptic* ; Meningitis, Bacterial ; Meningitis, Viral ; Polymerase Chain Reaction ; RNA, Viral ; Tuberculosis ; Tuberculosis, Meningeal

Acute aseptic meningitis is a rare complication of herpes zoster. It is usually regarded as a complication of the cutaneous infection in patients with impaired cellular immunity. Herpes zoster virus is a rare cause of viral meningitis. In one of three patients with herpes zoster meningitis, varicella-zoster virus DNA was detected by the polymerase chain reaction in the cerebrospinal fluid. We report three cases of acute aseptic meningitis followed by herpes zoster.
Cerebrospinal Fluid ; DNA ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Immunity, Cellular ; Meningitis ; Meningitis, Aseptic* ; Meningitis, Viral ; Polymerase Chain Reaction

Acute aseptic meningitis is a rare complication of herpes zoster. It is usually regarded as a complication of the cutaneous infection in patients with impaired cellular immunity. Herpes zoster virus is a rare cause of viral meningitis. In one of three patients with herpes zoster meningitis, varicella-zoster virus DNA was detected by the polymerase chain reaction in the cerebrospinal fluid. We report three cases of acute aseptic meningitis followed by herpes zoster.
Cerebrospinal Fluid ; DNA ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Immunity, Cellular ; Meningitis ; Meningitis, Aseptic* ; Meningitis, Viral ; Polymerase Chain Reaction

Aseptic meningitis, an acute inflammatory process of the meninges, is characterized by pleocytosis and absence of microorganisms on Gram stain and routine bacterial culture of CSF, and commonly occurs in children. Although aseptic meningitis occurs sporadically all the year round, in areas of temperate climates as in Korea, most cases occur in summer and fall, and the large scale epidemics draw a great deal of social concerns. Among the various etiologies, enteroviruses are the causative agents in about 85% of all cases. Although the clinical course is self-limited in most instances, substantial morbidity and mortality may be observed in some cases. In dealing with the patients of suggestive aseptic meningitis, it is important to rule out the diseases that are fatal but treatable.
Child ; Climate ; Enterovirus ; Humans ; Korea ; Leukocytosis ; Meninges ; Meningitis, Aseptic ; Meningitis, Viral ; Mortality

PURPOSE: Enteroviruses are the most common cause of aseptic meningitis in patients of all ages. A definite diagnosis of enteroviral meningitis can be established by detection of virus directly in CSF specimens. But this is time-consuming and lacks sensitivity, so polymerase chain reaction(PCR) detecting of viral RNA in patient specimens such as CSF, stool has been demonstrated. But little is known about the influence of sampling time on the results of CSF PCR and stool PCR. We investigated diagnostic utility of PCR of CSF and stool according to sampling time after the onset of symptoms. METHODS: PCR results were analyzed according to sampling time for 42 patients diagnosed aseptic meningits in our hospital from 11(th) January to 30(th) August, 2005. RESULTS: The diagnostic yield of the test was higher of CSF specimens obtained < or = 2 days after clinical onset(positive PCR results 9/18, 50 percent), compared with CSF collected >2 days after onset(positive PCR results 1/24, 4.2 percent)(P=0.001). Instead, positive PCR results of fecal specimens maintained highly(average 90.5 percent), 10 cases had also positive PCR results even 5-6 days after onset. 10 cases of CSF specimens had positive enterovirus PCR results containing coxsackievirus B5 (n=6), coxsackievirus B3(n=3). 38 cases of stool specimens had positive enterovirus PCR results containing echovirus 18(n=7), echovirus 9(n=3), coxsackievirus B5(n=8), coxsackievirus B3(n=3). 6 cases(coxackie B5) had positive CSF PCR and stool PCR, both. CONCLUSION: Stool PCR was clinically sensitive for detecting enterovirus during enteroviral meningits and could give a presumptive diagnosis throughout the disease course. A definite diagnosis was obtained by CSF PCR, but its utility was clearly lower for samples obtained >2 days after clinical onset. Therefore, it is recommended that, in addition to performance of CSF PCR, fecal samples obtained from patients with suspected enteroviral meningitis should be tested by PCR, especially when the duration of symptoms is >2 days.
Cerebrospinal Fluid ; Diagnosis ; Enterovirus ; Enterovirus B, Human ; Humans ; Meningitis ; Meningitis, Aseptic* ; Polymerase Chain Reaction ; RNA, Viral