Viral meningitis in Sudanese children: Differentiation, etiology and review of literature.


Journal

Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R

Informations de publication

Date de publication:
18 Nov 2022
Historique:
entrez: 19 11 2022
pubmed: 20 11 2022
medline: 23 11 2022
Statut: ppublish

Résumé

Diagnosis of viral meningitis (VM) is uncommon practice in Sudan and there is no local viral etiological map. We therefore intended to differentiate VM using standardized clinical codes and determine the involvement of herpes simplex virus types-1 and 2 (HSV-1/2), varicella zoster virus, non-polio human enteroviruses (HEVs), and human parechoviruses in meningeal infections in children in Sudan. This is a cross-sectional hospital-based study. Viral meningitis was differentiated in 503 suspected febrile attendee of Omdurman Hospital for Children following the criteria listed in the Clinical Case Definition for Aseptic/Viral Meningitis. Patients were children age 0 to 15 years. Viral nucleic acids (DNA/RNA) were extracted from cerebrospinal fluid (CSF) specimens using QIAamp® UltraSens Virus Technology. Complementary DNA was prepared from viral RNA using GoScriptTM Reverse Transcription System. Viral nucleic acids were amplified and detected using quantitative TaqMan® Real-Time and conventional polymerase chain reactions (PCRs). Hospital diagnosis of VM was assigned to 0%, when clinical codes were applied; we considered 3.2% as having VM among the total study population and as 40% among those with proven infectious meningitis. Two (0.4%) out of total 503 CSF specimens were positive for HSV-1; Ct values were 37.05 and 39.10 and virus copies were 652/PCR run (261 × 103/mL CSF) and 123/PCR run (49.3 × 103/mL CSF), respectively. Other 2 (0.4%) CSF specimens were positive for non-polio HEVs; Ct values were 37.70 and 38.30, and the approximate virus copies were 5E2/PCR run (~2E5/mL CSF) and 2E2/PCR run (~8E4/mL CSF), respectively. No genetic materials were detected for HSV-2, varicella zoster virus, and human parechoviruses. The diagnosis of VM was never assigned by the hospital despite fulfilling the clinical case definition. Virus detection rate was 10% among cases with proven infectious meningitis. Detected viruses were HSV-1 and non-polio HEVs. Positive virus PCRs in CSFs with normal cellular counts were seen.

Identifiants

pubmed: 36401437
doi: 10.1097/MD.0000000000031588
pii: 00005792-202211180-00077
pmc: PMC9678499
doi:

Substances chimiques

Nucleic Acids 0

Types de publication

Review Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e31588

Informations de copyright

Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

Déclaration de conflit d'intérêts

The authors have no funding and conflicts of interest to disclose.

Références

Rantakallio P, Leskinen M, von WL. Incidence and prognosis of central nervous system infections in a birth cohort of 12,000 children. Scand J Infect Dis. 1986;18:287–94.
Kupila L, Vuorinen T, Vainionpää R, et al. Etiology of aseptic meningitis and encephalitis in an adult population. Neurology. 2006;66:75–80.
World Health Organization and Global Alert Response Team. Meningococcal disease, African meningitis belt, epidemic season. 2006.
Peltola H. Burden of meningitis and other severe bacterial infections of children in Africa: implications for prevention. Clin Infect Dis. 2001;32:64–75.
Sylvie Z, Kolia-Diafouka P, Kania D, et al. Combined testing for herpes simplex virus and Mycobacterium tuberculosis DNA in cerebrospinal fluid of patients with aseptic meningitis in Burkina Faso, West Africa. JCLA. 2018;33:e22719.
Edridge AWD, Deijs M, Namazzi R, et al. Novel Orthobunyavirus identified in the cerebrospinal fluid of a Ugandan child with severe encephalopathy. Clin Infect Dis. 2019;68:139–42.
El-Amin EO, Elbashir MI, Elamin OE, et al. The underlying aetiologies of coma in febrile Sudanese children. Trans R Soc Trop Med Hyg. 2013;107:307–12.
Kakooza-Mwesige A, Mohammed AH, Kristensson K, et al. Emerging viral infections in sub-Saharan Africa and the developing nervous system: a mini review. Front Neurol. 2018;9:82.
Sedy JR, Spear PG, Ware CF. Cross-regulation between herpesviruses and the TNF superfamily members. Nat Rev Immunol. 2008;8:861–73.
Allawi HT, Li H, Sander T, et al. Invader plus method detects herpes simplex virus in cerebrospinal fluid and simultaneously differentiates types 1 and 2. J Clin Microbiol. 2006;44:3443–7.
Smalling TW, Sefers SE, Li H, et al. Molecular approaches to detecting herpes simplex virus and enteroviruses in the central nervous system. J Clin Microbiol. 2002;40:2317–22.
Espy MJ, Uhl JR, Sloan LM, et al. Real-time PCR in clinical microbiology: applications for routine laboratory testing. Clin Microbiol Rev. 2006;19:165–256.
Lee BE, Davies HD. Aseptic meningitis. Curr Opin Infect Dis. 2007;20:272–7.
Baumgarte S, de Souza Luna LK, Grywna K, et al. Prevalence, types, and RNA concentrations of human parechoviruses, including a sixth parechovirus type, in stool samples from patients with acute enteritis. J Clin Microbiol. 2008;46:242–8.
Watanabe K, Oie M, Higuchi M, et al. Isolation and characterization of novel human parechovirus from clinical samples. Emerg Infect Dis. 2007;13:889–95.
Mueller NH, Gilden DH, Cohrs RJ, et al. Varicella zoster virus infection: clinical features, molecular pathogenesis of disease, and latency. Neurol Clin. 2008;26:675–97, viii.
Abdelghani Abdelrahim N, Mohammed Fadl-Elmula I, Mohammed Ali H. Bacterial meningitis in Sudanese children; critical evaluation of the clinical decision using clinical prediction rules. BMC Pediatr. 2019;19:319.
Tapiainen T, Prevots R, Izurieta HS, et al. Brighton Collaboration Aseptic Meningitis Working Group. Aseptic meningitis: case definition and guidelines for collection, analysis and presentation of immunization safety data. Vaccine. 2007;25:5793–802.
Nix WA, Maher K, Pallansch MA, et al. Parechovirus typing in clinical specimens by nested or semi-nested PCR coupled with sequencing. J Clin Virol. 2010;48:202–7.
Abdelrahim NA, Mohamed N, Evander M, et al. Human Herpes virus type-6 is associated with central nervous system infections in children in Sudan. Afr J Lab Med. 2022;11:a1718.
Abdelghani Abdelrahim N, Mohammed Fadl-Elmula I, Rudy H, et al. Are pathogenic leptospira a possible cause of aseptic meningitis in suspected children in Sudan? Res Rep Trop Med. 2021;12:267–74.
Nigrovic LE, Kuppermann N, Malley R. Development and validation of a multivariable predictive model to distinguish bacterial from aseptic meningitis in children in the post-Haemophilus influenzae era. Pediatrics. 2002;110:712–9.
Thomson RB Jr, Bertram H. Laboratory diagnosis of central nervous system infections. Infect Dis Clin North Am. 2001;15:1047–71.
Zunt JR, Marra CM. Cerebrospinal fluid testing for the diagnosis of central nervous system infection. Neurol Clin. 1999;17:675–89.
Glaser CA, Gilliam S, Schnurr D, et al. California Encephalitis Project, 1998-2000. In search of encephalitis etiologies: diagnostic challenges in the California Encephalitis Project, 1998-2000. Clin Infect Dis. 2003;36:731–42.
Hosseininasab A, Alborzi A, Ziyaeyan M, et al. Viral etiology of aseptic meningitis among children in southern Iran. J Med Virol. 2011;83:884–8.
Li X, Guo X-ling, Shi Z-yang, et al. Etiology of aseptic meningitis prevalent in Xuzhou. Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2006;20:66–9.
Boucquey D, Chalon MP, Sindic CJ, et al. Herpes simplex virus type 2 meningitis without genital lesions: an immunoblot study. J Neurol. 1990;237:285–9.
Kohl S. Herpes simplex virus encephalitis in children. Pediatr Clin North Am. 1988;35:465–83.
Mitchell PS, Espy MJ, Smith TF, et al. Laboratory diagnosis of central nervous system infections with herpes simplex virus by PCR performed with cerebrospinal fluid specimens. J Clin Microbiol. 1997;35:2873–7.
Whitley RJ, Cobbs CG, Alford CA, et al. Diseases that mimic herpes simplex encephalitis. Diagnosis, presentation, and outcome. NIAD Collaborative Antiviral Study Group. JAMA. 1989;262:234–9.
Adler-Shohet FC, Cheung MM, Hill M, et al. Aseptic meningitis in infants younger than six months of age hospitalized with urinary tract infections. Pediatr Infect Dis J. 2003;22:1039–42.
Husain EH, Bahbahani E, Al-Shawaf F, et al. Aseptic meningitis among children in Kuwait. Med Princ Pract. 2008;17:122–5.
Wutzler P, Doerr HW, Färber I, et al. Seroprevalence of herpes simplex virus type 1 and type 2 in selected German populations-relevance for the incidence of genital herpes. J Med Virol. 2000;61:201–7.
Xu F, Sternberg MR, Kottiri BJ, et al. Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States. JAMA. 2006;296:964–73.
Lakeman FD, Whitley RJ. Diagnosis of herpes simplex encephalitis: application of polymerase chain reaction to cerebrospinal fluid from brain-biopsied patients and correlation with disease. National Institute of Allergy and Infectious Diseases Collaborative Antiviral study group. J Infect Dis. 1995;171:857–63.
Kimberlin DW. Herpes simplex virus infections of the central nervous system. Semin Pediatr Infect Dis. 2003;14:83–9.
Kimberlin D, Powell D, Gruber W, et al. Administration of oral acyclovir suppressive therapy after neonatal herpes simplex virus disease limited to the skin, eyes and mouth: results of a phase I/II trial. Pediatr Infect Dis J. 1996;15:247–54.
Reil H, Bartlime A, Drerup J, et al. Clinical validation of a new triplex real-time polymerase chain reaction assay for the detection and discrimination of Herpes simplex virus types 1 and 2. J Mol Diagn. 2008;10:361–7.
Markoulatos P, Georgopoulou A, Siafakas N, et al. Laboratory diagnosis of common herpesvirus infections of the central nervous system by a multiplex PCR assay. J Clin Microbiol. 2001;39:4426–32.
Hanson KE, Alexander BD, Woods C, et al. Validation of laboratory screening criteria for herpes simplex virus testing of cerebrospinal fluid. J Clin Microbiol. 2007;45:721–4.
Wildemann B, Ehrhart K, Storch-Hagenlocher B, et al. Quantitation of herpes simplex virus type 1 DNA in cells of cerebrospinal fluid of patients with herpes simplex virus encephalitis. Neurology. 1997;48:1341–6.
Domingues RB, Lakeman FD, Mayo MS, et al. Application of competitive PCR to cerebrospinal fluid samples from patients with herpes simplex encephalitis. J Clin Microbiol. 1998;36:2229–34.
Barnetson RS, Rogers M. Childhood atopic eczema. BMJ. 2002;324:1376–9.
Ando Y, Kimura H, Miwata H, et al. Quantitative analysis of herpes simplex virus DNA in cerebrospinal fluid of children with herpes simplex encephalitis. J Med Virol. 1993;41:170–3.
Revello MG, Baldanti F, Sarasini A, et al. Quantitation of herpes simplex virus DNA in cerebrospinal fluid of patients with herpes simplex encephalitis by the polymerase chain reaction. Clin Diagn Virol. 1997;7:183–91.
Peters AC, Versteeg J, Bots GT, et al. Nervous system complications of herpes zoster: immunofluorescent demonstration of varicella-zoster antigen in CSF cells. J Neurol Neurosurg Psychiatry. 1979;42:452–7.
honmaitree T. Baldwin CD, Lucia HL, Role of the virology laboratory in diagnosis and management of patients with central nervous system disease. Clin Microbiol Rev. 1989;2:1–14.
Echevarria JM, Casas I, Tenorio A, et al. Detection of varicella-zoster virus-specific DNA sequences in cerebrospinal fluid from patients with acute aseptic meningitis and no cutaneous lesions. J Med Virol. 1994;43:331–5.
Schlesinger Y, Tebas P, Gaudreault-Keener M, et al. Herpes simplex virus type 2 meningitis in the absence of genital lesions: improved recognition with use of the polymerase chain reaction. Clin Infect Dis. 1995;20:842–8.
Tedder DG, Ashley R, Tyler KL, et al. Herpes simplex virus infection as a cause of benign recurrent lymphocytic meningitis. Ann Intern Med. 1994;121:334–8.
Echevarria JM, Casas I, Martinez-Martin P. Infections of the nervous system caused by varicella-zoster virus: a review. Intervirology. 1997;40:72–84.
Koskiniemi M, Rantalaiho T, Piiparinen H, et al. Study Group. Infections of the central nervous system of suspected viral origin: a collaborative study from Finland. J Neurovirol. 2001;7:400–8.
World Health Organization. Global Polio Eradication Initiative Strategic plan 2009-2013, ed. Dept of Vaccines Biologicals. 2010, Geneva: World Health Organization.
Rotbart HA. Enteroviral infections of the central nervous system. Clin Infect Dis. 1995;20:971–81.
Beld M, Minnaar R, Weel J, et al. Highly sensitive assay for detection of enterovirus in clinical specimens by reverse transcription-PCR with an armored RNA internal control. J Clin Microbiol. 2004;42:3059–64.
Lo CW, Wu K-G, Lin M-C, et al. Application of a molecular method for the classification of human enteroviruses and its correlation with clinical manifestations. J Microbiol Immunol Infect. 2010;43:354–9.
Tan CY, Ninove L, Gaudart J, et al. A retrospective overview of enterovirus infection diagnosis and molecular epidemiology in the public hospitals of Marseille, France (1985-2005). PLoS One. 2011;6:e18022.
Strange GR, AWR. Meningitis: evidence to guide an evolving standard of care. Pediatr Emerg Med. 2005;2:24.
Chonmaitree T, Menegus MA, Schervish-Swierkosz EM, et al. Enterovirus 71 infection: report of an outbreak with two cases of paralysis and a review of the literature. Pediatrics. 1981;67:489–93.
Cherry JD. Enteroviruses: polioviruses (poliomyelitis), coxsackieviruses, echoviruses and enteroviruses. In: Textbook of Pediatric Infectious Diseases. Cherry JD, Feigin RD, eds. Philadelphia: W. B. Saunders Co, 1987:1729–90.
Bowen GS, Fisher MC, DeForest A, et al. Epidemic of meningitis and febrile illness in neonates caused by ECHO type 11 virus in Philadelphia. Pediatr Infect Dis. 1983;2:359–63.
Wilfert CM, Lehrman SN, Katz SL. Enteroviruses and meningitis. Pediatr Infect Dis. 1983;2:333–41.
Singer JI, Maur PR, Riley JP, et al. Management of central nervous system infections during an epidemic of enteroviral aseptic meningitis. J Pediatr. 1980;96(3 Pt 2):559–63.
Wildin S, Chonmaitree T. The importance of the virology laboratory in the diagnosis and management of viral meningitis. Am J Dis Child. 1987;141:454–7.
Lee BE, Chawla R, Langley JM, et al. Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of aseptic meningitis. BMC Infect Dis. 2006;6:68.
Harrison SA, Risser WL. Repeat lumbar puncture in the differential diagnosis of meningitis. Pediatr Infect Dis J. 1988;7:143–5.
Negrini B, Kelleher KJ, Wald ER. Cerebrospinal fluid findings in aseptic versus bacterial meningitis. Pediatrics. 2000;105:316–9.
Straussberg R, Harel L, Nussinovitch M, et al. Absolute neutrophil count in aseptic and bacterial meningitis related to time of lumbar puncture. Pediatr Neurol. 2003;28:365–9.
Shah SS, Hodinka RL, Turnquist JL, et al. Cerebrospinal fluid mononuclear cell predominance is not related to symptom duration in children with enteroviral meningitis. J Pediatr. 2006;148:118–21.
Haynes RE, Cramblett HG, Kronfol HJ. Echovirus 9 meningoencephalitis in infants and children. JAMA. 1969;208:1657–60.
Wilfert CM, Lauer BA, Cohen M, et al. An epidemic of echovirus 18 meningitis. J Infect Dis. 1975;131:75–8.
Lake AM, Lauer BA, Clark JC, et al. Enterovirus infections in neonates. J Pediatr. 1976;89:787–91.
Chonmaitree T, Menegus MA, Powell KR. The clinical relevance of ‘“CSF viral culture’..” A two-year experience with aseptic meningitis in Rochester, NY. JAMA. 1982;247:1843–7.
Krober MS, Bass JW, Powell JM, et al. Bacterial and viral pathogens causing fever in infants less than 3 months old. Am J Dis Child. 1985;139:889–92.
Henquell C, Chambon M, Bailly JL, et al. Prospective analysis of 61 cases of enteroviral meningitis: interest of systematic genome detection in cerebrospinal fluid irrespective of cytologic examination results. J Clin Virol. 2001;21:29–35.
Landry ML. Frequency of normal cerebrospinal fluid protein level and leukocyte count in enterovirus meningitis. J Clin Virol. 2005;32:73–4.
DeBiasi RL, Tyler KL. Molecular methods for diagnosis of viral encephalitis. Clin Microbiol Rev. 2004;17:903–25.

Auteurs

Nada Abdelghani Abdelrahim (NA)

Department of Pathology-Medical Microbiology, Faculty of Medicine, University of Medical Sciences and Technology, Khartoum, Sudan.

Nahla Mohammed (N)

Department of Clinical Microbiology, Umeå University, Umeå, Sweden.

Magnus Evander (M)

Department of Clinical Microbiology, Umeå University, Umeå, Sweden.

Clas Ahlm (C)

Department of Clinical Microbiology, Umeå University, Umeå, Sweden.

Imad Mohammed Fadl-Elmula (IM)

Department of Pathology & Clinical Genetics, Al-Neelain University & Assafa Academy, Khartoum, Sudan.

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