1998年夏期における無菌性髄膜炎の臨床的および神経生理学的検討(<特集>小児科学教室大澤真木子教授開講5周年記念)

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Aseptic meningitis, which is caused mainly by Echovirus 30, was epidemic between 1997 and 1998 throughout Japan. From April through September in 1998, 18 patients with aseptic meningitis were admitted to the Tokyo Women's Medical University Hospital. Their ages ranged from 25 days to 9 years (median 3.8 ± 2.9 years) ; 10 were males and 8 were females. Enteroviruses were the cause of meningitis in 14 patients (77%) and Echovirus 30 was isolated from 12 patients (40%). A total of 30 % of all patients were neonates and infants. The symptoms included fever (100%), headache (100 % in patients over 4 years), vomiting (77%), and neck stiffness (66%). Exanthema and diarrhea were infrequent, and ocular pain, impairment of consciousness, and convulsion were absent. Cerebrospinal fluid (CSF), throat swab and rectal swab samples were collected from all patients. These samples were examined for the presence of infectious virus using cell culture methods, and for virus genomes using polymerase chain reaction (PCR) methods. Enteroviruses were isolated from 7 (38 %) CSF samples, and viral genomes were detected by PCR in 14 (77%) samples; PCR may therefore be useful for the diagnosis of aseptic meningitis. A total of 7 patients (66%) were studied by electroencephalography (EEG) and brainstem auditory evoked potentials (ABR). EEG indicated mild dysrhythmia in 2 patients. ABR findings were normal. There were patients with positive isolation or PCR results without pleocytosis in CSF, had initially been given a diagnosis of meningism or acute gastroenterocolitis. EEG and neurological examination should be performed in all patients.
東京女子医科大学の論文
2000-06-25

1998年夏期における無菌性髄膜炎の臨床的および神経生理学的検討(<特集>小児科学教室大澤真木子教授開講5周年記念)

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