TY - JOUR
T1 - Central nervous system (CNS) enterovirus infections
T2 - A single center retrospective study on clinical features, diagnostic studies, and outcome
AU - Torres, Sarah D.
AU - Jia, Dan Tong
AU - Schorr, Emily M.
AU - Park, Brian L.
AU - Boubour, Alexandra
AU - Boehme, Amelia
AU - Ankam, Jyoti V.
AU - Gofshteyn, Jacqueline S.
AU - Tyshkov, Charles
AU - Green, Daniel A.
AU - Vargas, Wendy
AU - Zucker, Jason
AU - Yeshokumar, Anusha K.
AU - Thakur, Kiran T.
N1 - Publisher Copyright:
© 2019, Journal of NeuroVirology, Inc.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Enteroviruses (EV) are responsible for a large number of meningoencephalitis cases, especially in children. The objective of this study was to identify modes of diagnosis including the significance of respiratory and cerebrospinal fluid samples, associated clinical characteristics, inpatient management, and outcome of individuals with EV infections of the central nervous system (CNS). Electronic medical records of individuals with enterovirus infections of the CNS who presented to the Columbia University Irving Medical Center and Children’s Hospital of New York between January 1, 2012 and December 31, 2017 were reviewed retrospectively for demographic, epidemiological, and clinical data. The median age overall was 1.7 months (interquartile range 14 years) and most (62.4%) were male. The majority of CNS infections presented as meningitis (95.7%) and occurred in the summer (45.2%) and fall seasons (37.6%). Eighty-five cases (91.4%) demonstrated EV positivity in cerebrospinal fluid, thirty cases (32.3%) exhibited both cerebrospinal fluid and respiratory positivity, and eight cases (8.6%) exhibited respiratory positivity with coinciding neurological findings. Eighty-nine individuals overall (95.7%) received antibiotics and 37 (39.8%) received antiviral treatment. All surviving individuals had favorable Modified Rankin Scores (MRS) within the zero to two ranges upon discharge. Testing respiratory samples in addition to cerebrospinal fluid was found to be an important diagnostic tool in EV-associated cases. While clinical outcomes were favorable for an overwhelming majority of cases, etiological understanding of CNS infections is essential for identifying ongoing and changing epidemiological patterns and aid in improving the diagnosis and treatment.
AB - Enteroviruses (EV) are responsible for a large number of meningoencephalitis cases, especially in children. The objective of this study was to identify modes of diagnosis including the significance of respiratory and cerebrospinal fluid samples, associated clinical characteristics, inpatient management, and outcome of individuals with EV infections of the central nervous system (CNS). Electronic medical records of individuals with enterovirus infections of the CNS who presented to the Columbia University Irving Medical Center and Children’s Hospital of New York between January 1, 2012 and December 31, 2017 were reviewed retrospectively for demographic, epidemiological, and clinical data. The median age overall was 1.7 months (interquartile range 14 years) and most (62.4%) were male. The majority of CNS infections presented as meningitis (95.7%) and occurred in the summer (45.2%) and fall seasons (37.6%). Eighty-five cases (91.4%) demonstrated EV positivity in cerebrospinal fluid, thirty cases (32.3%) exhibited both cerebrospinal fluid and respiratory positivity, and eight cases (8.6%) exhibited respiratory positivity with coinciding neurological findings. Eighty-nine individuals overall (95.7%) received antibiotics and 37 (39.8%) received antiviral treatment. All surviving individuals had favorable Modified Rankin Scores (MRS) within the zero to two ranges upon discharge. Testing respiratory samples in addition to cerebrospinal fluid was found to be an important diagnostic tool in EV-associated cases. While clinical outcomes were favorable for an overwhelming majority of cases, etiological understanding of CNS infections is essential for identifying ongoing and changing epidemiological patterns and aid in improving the diagnosis and treatment.
KW - Acute flaccid myelitis
KW - Central nervous system infections
KW - Enterovirus
KW - Neurodiagnostics
KW - Pediatrics
UR - http://www.scopus.com/inward/record.url?scp=85073815585&partnerID=8YFLogxK
U2 - 10.1007/s13365-019-00784-5
DO - 10.1007/s13365-019-00784-5
M3 - Article
C2 - 31529280
AN - SCOPUS:85073815585
SN - 1355-0284
VL - 26
SP - 14
EP - 22
JO - Journal of NeuroVirology
JF - Journal of NeuroVirology
IS - 1
ER -