All issues > Volume 47(4); 2004

Original Article

Korean J Pediatr. 2004;47(4):392-398. Published online April 15, 2004.

Clinical and Virologic Study of Aseptic Meningitis

Hyun Ji HJ Kim¹, Hae Kwan HK Cheong², Cheoll C Jung², Kyu Man KM Lee³, Young Mee YM Jee⁴, Won Duck WD Kim¹, Dong Seok DS Lee¹, Doo Kwun DK Kim¹, Sung Min SM Choi¹

¹Department of Pediatrics, College of Medicine, Dongguk University, Gyeongju, Korea
²Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju, Korea
³Department of Clinical Pathology, College of Medicine, Hallym University, Seoul, Korea
⁴Laboratory of Enteroviruses, Department of Virology , National Institute of Health, Korea

Abstract

Purpose
: The cause of aseptic meningitis remains mostly unknown because viral culture and identification is difficult. Thus, we report a study on 123 children with aseptic meningitis in Gyeongju in 2002 to identify the causing virus and the relationship with the clinical manifestation.
Methods
: We prospectively investigated the patients, admitted to Dongguk University Hospital, into two groups between April and October 2002. Group 1 included 123 patients diagnosed as aseptic meningitis. Group 2, the adimssion control, included 120 patients, who suffered from none-enteroviral diseases. Specimens of CSF and stool were collected to perform reverse transcription polymerase chain reaction(RT-PCR), and enteroviral culuture was done in RT-PCR positive patients as well.
Results
: The male to female sex ratio was 2.2 : 1 and the mean age was 6.2?.7 years. The clinical manifestations were fever, headache and vomiting. The RT-PCR for enterovirus, performed in 58 cases of CSF in group 1, showed 5.2% positive results and negative result in viral culture. The RT- PCR for enterovirus used in stool specimens showed 89.3% and 41.1% of positive results in group 1 and group 2, respectively. Viral culture of stool specimens showed five cases of echovirus 13 and four cases of echovirus 6 in group 1, whereas three cases of echovirus 6 and one case of coxsackie B4 were detected in group 2.
Conclusion
: The etiologic viruses of the aseptic meningitis outbreak in Gyeongju in 2002 is presumed to be echovirus 13 and echovirus 6. Since echovirus 13 firstly appeared with various age distributions, the outbreak may have emerged due to a lack of acquisition of immunity to this virus.

Keywords :Aseptic meningitis, Reverse transcription polymerase chain reaction(RT-PCR), Enterovirus