The aim of this study was to determine the applicability of reverse transcription and polymerase chain reaction (RT/PCR) for routine diagnostic use and for the detection of enteroviral mentigitis. Primers were selected in the highly conserved part of the 5'-non-coding of the enteroviral genome. Enteroviral RNA was detected by the RT/PCR in routinely collected cerebrospinal fluids (CSF) of patients with aseptic meningitis who had admitted to the dept. Of Pediatrics. MinJoong Hospital, KonKuk University from May to July 1993. Enteroviral RNA was detected in one third of CSF specimen. Our results demonstrate the significance of the RT/PCR in the diagnosis of enteroviral meningitis.
Cerebrospinal Fluid ; Diagnosis ; Enterovirus* ; Genome ; Humans ; Meningitis ; Meningitis, Aseptic* ; Pediatrics ; Polymerase Chain Reaction* ; Reverse Transcription* ; RNA

PURPOSE: Acute abdominal pain in an epidemic aseptic meningitis which is mostly an enterovirus as causative agent, is noted in 23-55% of patients. An enterovirus is also known as one of the causes of acute nonspecific mesenteric lymphadenitis(ANML). The purpose of this study was to see if ANML was associated with acute abdominal pain in epidemic aseptic meningitis. METHODS: Between June 2001 and July 2001, data from 30 patients, aged 3 years to 14 years, with aseptic meningitis was reviewed. Abdominal ultrasonography was performed on all the patients and ANML was defined as a cluster of five or more lymph nodes measuring 5 mm or greater in their longitudinal diameter in the right lower quadrant with no identifiable specific inflammatory process. RESULTS: The clinical symptoms of the 30 patients were:fever(76.7%), vomiting(90.0%), diarrhea(20.0%) and abdominal pain(40.0%). The average peripheral blood leukocytes count on admission was 7,996+/-2,701(4,500-14,500)/mm(3). ANML, according to the ultrasonography, was shown in 93.3% of aseptic meningitis patients; the number of mesenteric nodes was 9.2+/-5.3(5-20), with 7.4% of the 27 control cases being mesenteric nodes positive(P<0.05). The patients with ANML were divided into two groups; those with and without abdominal pain, 42.9% and 57.1% respectively. Two patients without ANML showed no abdominal pain. The count of mesenteric nodes was not significantly correlated with the duration to diagnosis, with or without fever, peripheral blood leukocytes count, and with or without abdominal pain. CONCLUSION: ANML is presumed to be a cause of the acute abdominal pain in epidemic aseptic meningitis. Further clinical observations are recommended on the reason why ANML can be associated with and without abdominal pain.
Abdominal Pain* ; Diagnosis ; Enterovirus ; Fever ; Humans ; Leukocytes ; Lymph Nodes ; Meningitis ; Meningitis, Aseptic* ; Mesenteric Lymphadenitis* ; Ultrasonography

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

Meningitis-retention syndrome (MRS) is a clinical entity that has recently appeared in the literature. We present the case of a 22-year-old man with fever and headache who, in the course of his hospitalization with a diagnosis of aseptic meningitis, developed acute urinary retention. Fewer than 30 such cases have been described and in several of them, no clear associations with other disorders have been made. In some cases, direct association with viral infection has been proved, and in others, there are indications of an underlying demyelinating condition. To further complicate the issue, various conditions such as Elsberg syndrome and acute disseminated encephalomyelitis, which not only have some similarities but also have some distinct differences, have been placed under the umbrella definition of MRS. In our review, we attempt to address these conditions and better define MRS by establishing diagnostic criteria based on what has thus far been described in the literature.
Autoimmunity ; Diagnosis ; Encephalomyelitis, Acute Disseminated ; Fever ; Headache ; Hospitalization ; Humans ; Meningitis ; Meningitis, Aseptic ; Urinary Retention ; Young Adult

Behcet's disease is a systemic vasculitis that is characterized mainly by recurrent oral and genital aphthous ulcers, uveitis, and skin findings. Its neurological manifestations are well recognized. Recurrent meningitis in Behcet's disease is exceptional. We describe herein the case of a 31-year-old man who presented with recurrent aseptic meningitis without any specific cause. A few years later he developed oral and genital ulcers, and uveitis. Behcet's disease should always be considered in a differential diagnosis of recurrent aseptic meningitis without viral infection, particularly in the context of multisystem manifestations.
Adult ; Diagnosis, Differential ; Humans ; Meningitis ; Meningitis, Aseptic ; Neurologic Manifestations ; Skin ; Stomatitis, Aphthous ; Systemic Vasculitis ; Ulcer ; Uveitis

The Measurement of CSF glucose and CSF glucose-to-blood glucose ratio is a very useful laboratory test for the differential diagnosis of meningitis. We have observed the change of blood glucose & CSF glucose-to-blood glucose ratio according to the time of blood sampling in 84 patients with aseptic meningitis who had been admitted to the department of pediatrics, Dong Kang hospital from May 1993 to June 1993. The results obtained were as follows: 1) The blood glucose level examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 98.29+/-16.20mg/dl and 106.49+/-19.47mg/dl, respectively. 2) The blood glucose level examined with blood sample drawn just before lumbar puncture and one 30 min. after lumbar puncture was 96.47+/-21.52mg/dl and 117.00+/-22.12mg/dl, respectively. 3) The CSF glucose-to-blood glucose ratios examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 67.70+/-12.40% and 62.83+/-12.62%, respectively. 4) The CSF glucose-to-blood glucose ratios examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 70.10+/-21.77% and 56.35+/-13.75%, reskpectively. We concluded that a simultaneous blood glucose level should be taken just before lumbar puncture.
Blood Glucose ; Diagnosis, Differential ; Glucose* ; Humans ; Meningitis ; Meningitis, Aseptic* ; Pediatrics ; Spinal Puncture

Acute human immunodeficiency virus (HIV) syndrome develops in 40 to 90% of new HIV-1 infections. In Korea, recent increases in HIV-1 infection rates suggest that the number of patients experiencing acute HIV syndrome will also increase. Furthermore, it has been reported that aseptic meningitis occurs in 24% of patients with acute HIV syndrome. The inclusion of acute HIV syndrome in the differential diagnosis of aseptic meningitis is crucial; however, few reports of acute HIV syndrome presenting as aseptic meningitis in Korea exist. Here we report a case of aseptic meningitis in a patient who received early antiretroviral therapy after a diagnosis of acute HIV syndrome.
Diagnosis, Differential ; HIV ; HIV Infections ; HIV-1 ; Humans ; Korea ; Meningitis ; Meningitis, Aseptic

Acute human immunodeficiency virus (HIV) syndrome develops in 40 to 90% of new HIV-1 infections. In Korea, recent increases in HIV-1 infection rates suggest that the number of patients experiencing acute HIV syndrome will also increase. Furthermore, it has been reported that aseptic meningitis occurs in 24% of patients with acute HIV syndrome. The inclusion of acute HIV syndrome in the differential diagnosis of aseptic meningitis is crucial; however, few reports of acute HIV syndrome presenting as aseptic meningitis in Korea exist. Here we report a case of aseptic meningitis in a patient who received early antiretroviral therapy after a diagnosis of acute HIV syndrome.
Diagnosis, Differential ; HIV ; HIV Infections ; HIV-1 ; Humans ; Korea ; Meningitis ; Meningitis, Aseptic

By means of a sensitive radioirnrnunoassay method,ferritin was assessed in the cerebrospinal fluid (CSF) of 50 hospitalized subjects to evaluate its potential value for the diagnosis of tuberculous rneningititis. The rnean ferritin value obtained in the controls was 4.29ng /rnl with ranging between 1.7 and7.4ng/rmL The differences of CSF ferritin content between controls and patients with aseptic rneningitis as well as other non-infectious neurologic disorder were not significant. But rnarked elevation ranging 14 and 88ng/rnl (rnean, 37.4ng/rnl) were observed in patients with tuberculous rneningitis. And the ratio of CSF ferritin to serum ferritin in paients with tuberculous rneningitis was elevated significantly rnore than those in other groups inculuding controls, patients with aseptic rneningitis and other non-infectious neurologic disorder. The level in the serurn and CSF were independent, but that in CSF correlated vrith its total protein content. Results of this study suggest rneasuring CSF ferritin level are a valuable adjunct in differentiating aseptic meningitis from uncomplicated tuberculous meningitis.
Cerebrospinal Fluid ; Diagnosis ; Ferritins* ; Humans ; Meningitis* ; Meningitis, Aseptic ; Nervous System Diseases ; Tuberculosis, Meningeal

PURPOSE: To identify the factors associated with differential diagnosis of neonatal bacterial meningitis at the earliest opportunities possible and to evaluate the value of the bacterial meningitis score especially in neonates. METHODS: We conducted a single-center, retrospective study of neonates diagnosed meningitis at our hospital between January 2000 and March 2014. We compared the general characteristics, clinical manifestations, laboratory findings, bacterial meningitis scores between the bacterial group and the aseptic group. RESULTS: Bacterial meningitis differs significantly from aseptic meningitis in platelet count, the cerebrospinal fluid polymorphonuclear leukocyte count, and the serum protein including also the albumin (P<0.05). Except two infants, the bacterial meningitis score over 2 accurately predict bacterial meningitis in the other 11 infants. CONCLUSION: The bacterial meningitis score appears highly useful to identify neonatal infants with bacterial meningitis. However, its diagnostic and prognostic value is just ‘adjunctive’, because low score cannot rule out bacterial meningitis.
Cerebrospinal Fluid ; Diagnosis, Differential ; Humans ; Infant ; Infant, Newborn* ; Meningitis* ; Meningitis, Aseptic ; Meningitis, Bacterial* ; Neutrophils ; Platelet Count ; Retrospective Studies