Enteroviral serous meningitis in adults: Real practice

Abstract

Darya Khavkina

Statement of the Problem: The frequency of serous meningitis in the structure of infectious lesions of the central nervous system reaches 70%. The main etiological role belongs to enteroviruses of different etiologies. The article presents the features of laboratory diagnosis of serous meningitis of enterovirus etiology in a 28-year-old man. Methodology & Theoretical Orientation: The patient was taken to Department of Infectious Diseases in Moscow in moderate condition. He said that two days ago he returned from the Crimea, where there was an epidemic focus of enterovirus infection. Examination of the patient showed severe catarrhal syndrome, fever and the presence of mild meningeal symptoms. Findings: The patient was examined, including a general blood test, a general urine test, a bacterial stool test, a fecal polymerase chain reaction test, an HIV test, syphilis, hepatitis and a cerebrospinal fluid test for polymerase chain reaction, sterility and a general cerebrospinal fluid test. PCR of feces revealed the presence of enterovirus. The general analysis of cerebrospinal fluid showed no significant changes, as well as the analysis of cerebrospinal fluid for sterility. Other studies also found no significant abnormalities and confirmed none of the previously reported infections. In three days the classic pattern of cerebral edema began to grow. PCR of the cerebrospinal fluid revealed an enterovirus. Treatment of the infection was carried out in accordance with Russian standards of Medical Care. The patient was discharged in satisfactory condition. Conclusion & Significance: Differential diagnosis of serous meningitis of enterovirus etiology in adults is a difficult task, because the usual meningeal symptom complex is poorly expressed and its prevalence is hard to understand. This problem requires a more detailed study. Today we are confident that in the complex diagnosis of enterovirus infection it is necessary to include in the analysis of cerebrospinal fluid on PCR.