Clinical and laboratory characteristics of enteroviral meningitis in adults

Abstract

The aim is to detect and characterize clinical symptoms and laboratory abnormalities in adult patients with enteroviral meningitis. Materials and methods. 39 cases of enteroviral meningitis in adults were analyzed. The average age of the patients was 24.05 ± 0.91 years. Among them were 20 men and 19 women. The comparison group consisted of 12 patients without diseases of the central nervous system. We analyzed the clinical symptoms, indicators of complete blood count, clinical analysis of cerebrospinal fluid (CSF), as well as the level of neuron-specific enolase (NSE), lactate, LDG, cortisol, creatine kinase and cholinesterase in the CSF of patients at the time of admission and on 10–12 day of treatment. Results. The disease is characterized by acute onset with fever, headache, photophobia, sore throat, cough, dyspeptic symptoms. Patients hospitalized at 3.33 ± 0.27 day of illness. Noteworthy is the absence or weak expression of meningeal signs in more than 76 % of cases. In the clinical analysis of the CSF we discovered two types of change – in 24 (61.54 %) cases dominated lymphocytes, while in 15 (38.46 %) predominated neutrophils. In the first day after admission CSF levels of creatinine kinase and lactate was significantly higher and levels of cortisol, cholinesterase and lactate dehydrogenase was significantly lower compared with the control group (P ˂ 0.05). Conclusions. Enteroviral meningitis is found mostly in young people. It is characterized by acute onset with typical symptoms of meningeal syndrome, but meningeal signs in most patients are mild (61.54 %) or negative (15.39 %). Clinical analysis of CSF is characterized by typical for aseptic meningitis changes, but in 38.46 % cases neutrophil level was above 50 %. In the acute phase there is a significant increased CSF level of cortisol, lactate, NSE, CK and decrease of LDH and cholinesterase, which can be used in differential diagnosis and evaluation of pathogenic disorders.