LABORATORY PARAMETERS OF CEREBROSPINAL FLUID IN INDIVIDUALS WITH ENTEROVIRUS MENINGITIS: A DESCRIPTIVE STUDY

Autores

  • Flavio Geraldes Alves Laboratório de Delineamento de Estudos e Escrita Científica. Departamento de Ciências Básicas. Faculdade de Medicina do ABC. / Disciplina de Neurologia da Infância e da Adolescência. Faculdade de Medicina do ABC.
  • Rubens Wajnsztejn Laboratório de Delineamento de Estudos e Escrita Científica. Departamento de Ciências Básicas. Faculdade de Medicina do ABC. / Disciplina de Neurologia da Infância e da Adolescência. Faculdade de Medicina do ABC.
  • Camila Almeida Exposto Alves Laboratório de Delineamento de Estudos e Escrita Científica. Departamento de Ciências Básicas. Faculdade de Medicina do ABC. / Disciplina de Neurologia da Infância e da Adolescência. Faculdade de Medicina do ABC.
  • Tassiane Cristina Morais Laboratório de Delineamento de Estudos e Escrita Científica. Departamento de Ciências Básicas. Faculdade de Medicina do ABC.
  • Mahmi Fujimori Laboratório de Delineamento de Estudos e Escrita Científica. Departamento de Ciências Básicas. Faculdade de Medicina do ABC.
  • Fernando Adami Laboratório de Delineamento de Estudos e Escrita Científica. Departamento de Ciências Básicas. Faculdade de Medicina do ABC.
  • Cícero Macedo Cruz Laboratório de Delineamento de Estudos e Escrita Científica. Departamento de Ciências Básicas. Faculdade de Medicina do ABC./Docente do Departamento de pediatria da Universidade Federal do Cariri- UFCA. Barbalha, CE, Brasil
  • Luiz Carlos de Abreu Laboratório de Delineamento de Estudos e Escrita Científica. Departamento de Ciências Básicas. Faculdade de Medicina do ABC.

DOI:

https://doi.org/10.7322/jhgd.103022

Palavras-chave:

enterovirus, cerebrospinal fluid, viral meningitis.

Resumo

Introduction: Meningitis is the leading infectious syndrome that affects the central nervous system, and most cases are caused by viral infections, mainly enterovirus. The clinical diagnosis for meningitis etiology still presents major challenges. The analysis of polymerase chain reaction (PCR), white blood cells, red blood cells, glucose, protein, and lactate in the cerebrospinal fluid (CSF) provides the first clues to the diagnosis. However, the reference values of some parameters can suffer changes. Objective: Analyze laboratory parameters of CSF in patients with enterovirus meningitis according to age. Methods: A descriptive study was conducted based on data from a CSF reference service, located in São Paulo, Brazil, on 202 individuals who had enterovirus meningitis. Data was analysed by the Shapiro–Wilk and Kruskal–Wallis tests (CI = 95%, p <0.05) and represented by the median and percentile 25 and 75, respectively. Results: The cytological and biochemical parameters of the CSF shows us that proteins had median concentrations of 33.0mg/dL, glucose of 57.0mg/dl, lactate of 19.0mg/dL and the leukocyte of 119.0 cells/mm 3, with a predominance of lymphocytes (42%). It was found that age can cause cytological and biochemical changes in the parameters of CSF. Children younger than 2 years had a range percentage of neutrophils and monocytes different then children aged e” 2 and <6 years, and aged e” 6 and <10 years. The protein concentration range in CSF as well as glucose track can also change according to age. Conclusion: Age may lead to changes in cytological and biochemical parameters of CSF. CSF protein and glucose concentrations also change according to age.

Referências

Almeida SM, Nogueira MB, Raboni SM, Vidal LR. Laboratorial diagnosis of lymphocytic meningitis. Braz J Infect Dis. 2007;11(5):489-95. DOI: http://dx.doi.org/10.1590/S1413-86702007000500010

Mohseni MM, Wilde JA. Viral meningitis: Which patients can be discharged from the emergency department J Emerg Med. 2012; 43(6): 1181-7. DOI: http://dx.doi.org/10.1016/j.jemermed.2012.03.021

Kumar R. Aseptic Meningitis: Diagnosis and Management. Indian J Pediatr. 2005;72(1):57-63.

Swanson PA, McGavern DB. Viral diseases of the central nervous system. Curr Opin Virol. 2015; 11: 44–54. DOI: http://dx.doi.org/10.1016/j.coviro.2014.12.009

Rice P. Viral meningitis and encephalitis. Medicine. 2013; 41(12): 678–82. DOI: http://dx.doi.org/10.1016/j.mpmed.2013.09.005

Shaker OG, Abdelhamid N. Detection of enteroviruses in pediatric patients with aseptic meningitis. Clin Neurol Neurosurg. 2015; 129:67–71. DOI: http://dx.doi.org/10.1016/j.clineuro.2014.12.004

Chadwick DR. Viral meningitis. Br Med Bull. 2006;75-76:1–14. DOI: http://dx.doi.org/10.1093/bmb/ldh057

Giulieri SG, Chapuis-Taillard C, Manuel O, Hugli O, Pinget C, Wasserfallen J-B, et al. Rapid detection of enterovirus in cerebrospinal fluid by a fully-automated PCR assay is associated with improved management of aseptic

meningitis in adult patients. J Clin Virol. 2015;62:58–62. DOI: http://dx.doi.org/10.1016/j.jcv.2014.11.0 01

Hong J, Kim A, Hwang S, Cheon DS, Kim JH, Lee JW, et al. Comparison of the genexpert enterovirus assay (GXEA) with real-time one step RT-PCR for the detection of enteroviral RNA in the cerebrospinal fluid of patients with

meningitis. Virol J. 2015;12:27. DOI: http://dx.doi.org/10.1186/s12985-015-0258-8

Kumar A, Shukla D, Kumar R, Idris MZ, Misra UK, Dhole TN. Molecular epidemiological study of enteroviruses associated with encephalitis in children from India. J Clin Microbiol. 2012; 50(11):3509–12. DOI: http://dx.doi.org/

1128/JCM.01483-12

Tapparel C, Siegrist F, Petty TJ, Kaiser L. Picornavirus and enterovirus diversity with associated human diseases. Infect Genet Evol. 2013; 14:282-93. DOI: http://dx.doi.org/10.1016/j.meegid.2012.10.016

Bremell D, Mattsson N, Wallin F, Henriksson J, Wall M, Blennow K, et al. Automated cerebrospinal fluid cell count-new reference ranges and evaluation of its clinical use in central nervous system infections. Clin Biochem. 2014;47(1-2):25–30. DOI: http://dx.doi.org/10.1016/j.clinbiochem.2013.11.010

Negrini B, Kelleher KJ, Wald ER. Cerebrospinal fluid findings in aseptic versus bacterial DOI: http://dx.doi.org/10.1542/peds.105.2.316

Sakushima K, Hayashino Y, Kawaguchi T, Jackson JL, Fukuhara S. Diagnostic accuracy of cerebrospinal fluid lactate for differentiating bacterial meningitis from aseptic meningitis: a meta-analysis. J Infect. 2011;62(4):255–62.

DOI: http://dx.doi.org/10.1016/j.jinf.2011.02.010

Chadwick DR, Lever AM. The impact of new diagnostic methodologies in the management of meningitis in adults at a teaching hospital. QJM. 2002; 95(1):663–70. DOI: http://dx.doi.org/10.1093/qjmed/95.10.663

Chadwick SL, Wilson JW, Levin JE, Martin JM. Cerebrospinal fluid characteristics of infants who present to the emergency department with fever: establishing normal values by week ofage. Pediatr Infect Dis J. 2011; 30(4):e63–7. DOI: http://dx.doi.org/10.1097/INF.0b013e31820ad2ba

Messacar K, Breazeale G, Wei Q, Robinson CC, Dominguez SR. Epidemiology and clinical characteristics of infants with Human Parechovirus or Human Herpes Virus-6 detected in cerebrospinal fluid tested for Enterovirus or Herpes Simplex Virus. J Med Virol. 2015; 87(5): 829–35. DOI: http://dx.doi.org/10.1002/jmv.24119

White K, Ostrowski K, Maloney S, Norton R. The utility of cerebrospinal fluid parameters in the early microbiological assessment of meningitis. Diagn Microbiol Infect Dis. 2012;73(1):27–30. DOI: http://dx.doi.org/

1016/j.diagmicrobio.2012.02.010

Seo J, Yeom JS, Youn H, Han T, Chung J. Prevalence of human parechovirus and enterovirus in cerebrospinal fluid samples in children in Jinju, Korea. Korean J Pediatr. 2015; 58(3):102–7. DOI: http://dx.doi.org/10.3345/kjp.2015.58.3.102

Zeleke A, Chanie T, Woldie, M. Medication prescribing errors and associated factors at the pediatric wards of Dessie Referral Hospital, Northeast Ethiopia. Inter Arc Med. 2014;7:18. DOI: http://dx.doi.org/10.1186/1755-7682-7-18

Atrash H, Carpentier R. The evolving role of public health in the delivery of health care. J Hum Growth Dev. 2012; 22(3): 396-399.

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Publicado

2015-10-20

Edição

v. 25 n. 2 (2015)

Seção

Pesquisa Original

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