Clinical characteristics of 109 children with positive human enterovirus in cerebrospinal fluid samples
10.3760/cma.j.cn311365-20240711-00205
- VernacularTitle:脑脊液人肠道病毒阳性儿童109例的临床特征分析
- Author:
Yi ZHU
1
;
Yuanyuan ZHOU
;
Lingfeng CAO
;
Roujian LU
;
Wenjie TAN
;
Yong ZHANG
;
Jun SHEN
Author Information
1. 国家儿童医学中心 复旦大学附属儿科医院感染传染科，上海 201102
- Publication Type:Journal Article
- Keywords:
Children;
Human enterovirus;
Cerebrospinal fluid;
Central nervous system infection
- From:
Chinese Journal of Infectious Diseases
2024;42(9):533-537
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the positive rate of human enterovirus (EV) in cerebrospinal fluid (CSF) samples, and the clinical characteristics of children with positive results.Methods:A retrospective cross-sectional study was conducted to analyze the EV detection results of CSF samples from Children′s Hospital of Fudan University from January 2018 to March 2024. The clinical data including clinical diagnosis, clinical manifestations, CSF test, electroencephalogram (EEG) and cranial imaging examination, use of intravenous immunoglobulin (IVIg), and prognosis of the children with positive results were collected.Results:A total of 7 025 CSF samples collected from 6 614 children were sent for EV testing. The positive rate of EV in CSF samples was 1.7%(117/7 025), and the positive rates in spring, summer, autumn and winter were 6.7‰(11/1 645), 37.9‰(76/2 003), 12.5‰(21/1 680), and 5.3‰(9/1 697), respectively. The overall positive rate of total cases was 1.6%(109/6 614). The 109 positive cases were aged 60 days (two days to 13 years old). The clinical diagnosis of central nervous system infection was 64.2%(70/109), and sepsis was 24.8%(27/109). Fever, consciousness disorder and convulsion were present in 78.0%(85/109), 25.7%(28/109) and 17.4%(19/109) of cases, respectively. Among the 91 cases who completed cranial computed tomography and/or magnetic resonance imaging, abnormal brain lesions, ventriculomegaly and brain hernia were present in 31.9%(29/91), 26.4%(24/91) and 1.1%(1/91) of cases, respectively. While among the 76 cases who completed EEG, abnormalities were present in 38.2%(29/76) of cases. A total of 73 cases were hospitalized, with 19.2%(14/73) receiving IVIg, nine cases resulting in sequelae and one death which accounted for 13.7%(10/73) of hospitalized cases. Elevated white blood cells, decreased glucose, and increased protein in CSF were present in 40.2%(47/117), 35.9%(42/117), and 21.4%(25/117) of cases, respectively.Conclusions:From January 2018 to March 2024, the positive rate of EV in CSF sent for detection in Children′s Hospital of Fudan University is low, with the highest rate in summer. Children with positive results often have clinical features such as fever, consciousness disorder and convulsion. Some hospitalized children have sequelae or died.
