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PLoS One 2021 11;16(6):e0251518. Epub 2021 Jun 11.

Department of Microbiology and Immunology, Faculty of Pharmacy, Al-Azhar University, Assiut, Egypt.

Objectives: Meningitis is a medical emergency with permanent disabilities and high mortality worldwide. We aimed to determine causative microorganisms and potential markers for differentiation between bacterial and viral meningitis.

Methodology: Adult patients with acute meningitis were subjected to lumber puncture. Read More

Clin Lab 2021 Jun;67(6)

Background: The pathogens involved in central nervous system (CNS) infections are various, such as viruses, bacteria, and fungi, so a syndromic approach can be required. In addition, since their rapid and accurate detection is very crucial, molecular diagnostics using cerebrospinal fluid is becoming the emerging standard method.

Methods: The study was conducted retrospectively to identify the incidence and distribution patterns of the pathogens according to gender, age, season, and month and to analyze their codetection from August 2017 to July 2020. Read More

Virol J 2021 Jun 6;18(1):118. Epub 2021 Jun 6.

WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory of biosafety, National Health Commission Key Laboratory of Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People's Republic of China.

Background: An outbreak of aseptic meningitis occurred from June to August 2016, in Inner Mongolia Autonomous Region, China.

Methods: To determine its epidemiological characteristics, etiologic agent, and possible origin, specimens were collected for virus isolation and identification, followed by molecular epidemiological analysis.

Results: A total of 363 patients were clinically diagnosed from June 1st to August 31st 2016, and most cases (63. Read More

J Clin Virol 2021 Jul 11;140:104853. Epub 2021 May 11.

Laboratório de Vírus, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Minas Gerais, Brazil. Electronic address:

Background: Viruses are a common cause of central nervous system (CNS) infections. However, studies of CNS viral pathogens in pediatric patients are poorly explored because viral infections are often erroneously diagnosed as bacterial infections.

Methods: 299 CNS samples were collected from pediatric patients aged from one month to 14 years old. Read More

Wiad Lek 2021 ;74(5):1274-1276

SUMY STATE UNIVERSITY, SUMY, UKRAINE.

Objective: The aim: To pay attention of clinicians to possible lesions of the central nervous system (encephalitis) in patients with COVID-19.

Patients And Methods: Case presentation: A 44-year-old woman was admitted to our clinic because of 2-month-history of mild fever, bilateral lower lobe pneumonia, respiratory failure, generalized weakness, and some neurologic symptoms. SARS-CoV-2 RNA was detected in nasopharyngeal swab. Read More

Arch Pathol Lab Med 2021 Jun 4. Epub 2021 Jun 4.

From the Division of Critical Care and Hospitalist Neurology, Department of Neurology (Waldrop, Radmard, Thakur), Columbia University Irving Medical Center, New York, New York.

Context.—: The FilmArray Meningitis/Encephalitis (ME) panel is the first US Food and Drug Administration-cleared multiplex polymerase chain reaction panel for the detection of central nervous system infections. While the assay's performance characteristics have been described, the real-world significance of positive results has not been fully characterized. Read More

Pathogens 2021 May 31;10(6). Epub 2021 May 31.

American Type Culture Collection (ATCC®), ATCC Federal Solutions, 10801 University Boulevard, Manassas, VA 20110, USA.

Powassan virus (POWV) is a tick-borne flavivirus circulating in North America and the Russian Far East that can cause severe neuroinvasive diseases, including encephalitis, meningitis, and meningoencephalitis. The reported neuroinvasive case fatality is about 10%, and approximately 50% of the survivors from the neuroinfection exhibit long-lasting or permanent neurological sequelae. Currently, treatment of POWV infection is supportive, and no FDA-approved vaccines or specific therapeutics are available. Read More

Pathogens 2021 May 17;10(5). Epub 2021 May 17.

IHU Méditerranée Infection, 13005 Marseille, France.

The current point-of-care diagnosis of enterovirus meningitis does not identify the viral genotype, which is prognostic. In this case report, more than 81% of an 12 genome were detected and identified by metagenomic next-generation sequencing, directly from the cerebrospinal fluid collected in a 6-month-old child with meningeal syndrome and meningitis: introducing 12 as an etiological agent of acute meningitis in the pediatric population. Read More

Cells 2021 May 6;10(5). Epub 2021 May 6.

Research Group Biomarkers for Infectious Diseases, TWINCORE Centre for Experimental and Clinical Infection Research, 30625 Hannover and Helmholtz Centre for Infection Research, 38124 Braunschweig, Germany.

The identification of CSF biomarkers for bacterial meningitis can potentially improve diagnosis and understanding of pathogenesis, and the differentiation from viral CNS infections is of particular clinical importance. Considering that substantial changes in CSF metabolites in CNS infections have recently been demonstrated, we compared concentrations of 188 metabolites in CSF samples from patients with bacterial meningitis ( = 32), viral meningitis/encephalitis ( = 34), and noninflamed controls ( = 66). Metabolite reprogramming in bacterial meningitis was greatest among phosphatidylcholines, and concentrations of all 54 phosphatidylcholines were significantly ( = 1. Read More

Viruses 2021 May 11;13(5). Epub 2021 May 11.

Institute of Medical Microbiology and Virology, Leipzig University Hospital, 04103 Leipzig, Germany.

Enteroviruses are associated with various diseases accompanied by rare but severe complications. In recent years, outbreaks of enterovirus D68 and enterovirus A71 associated with severe respiratory infections and neurological complications have been reported worldwide. Since information on molecular epidemiology in respiratory samples is still limited, the genetic diversity of enteroviruses was retrospectively analysed over a 4-year period (2013-2016) in respiratory samples from paediatric patients. Read More

Acta Med Port 2021 May 28. Epub 2021 May 28.

Centro de Estudos de Vectores e Doenças Infecciosas Dr. Francisco Cambournac. Instituto Nacional de Saúde Dr. Ricardo Jorge. Águas de Moura. Portugal.

Introduction: Toscana virus (TOSV) is an emerging sandfly-borne virus within the Phlebovirus genus. Although most infections caused by this virus present as asymptomatic or with minimal symptomatology, TOSV may emerge as a febrile disease or sporadic cases of neurological disease such as meningitis or meningoencephalitis. This pathogen is distributed throughout the Mediterranean basin, along with the spatial distribution of its recognized sandfly vector, Phlebotomus perniciosus. Read More

Pediatr Emerg Care 2021 May 26. Epub 2021 May 26.

From the Senne Liquor Diagnóstico Virology Section (LIM-52), Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil.

Background: The etiology of central nervous system infections is often difficult to establish. FilmArray meningitis/encephalitis (ME) panel is a multiplex polymerase chain reaction for rapid identification of 14 pathogens. The aim of this study was to evaluate potential real-life contributions of the use of this method in the pediatric population. Read More

Lancet Digit Health 2021 06;3(6):e360-e370

Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Dublin, Ireland; Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.

Background: Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis, which are typically transmitted via respiratory droplets, are leading causes of invasive diseases, including bacteraemic pneumonia and meningitis, and of secondary infections subsequent to post-viral respiratory disease. The aim of this study was to investigate the incidence of invasive disease due to these pathogens during the early months of the COVID-19 pandemic.

Methods: In this prospective analysis of surveillance data, laboratories in 26 countries and territories across six continents submitted data on cases of invasive disease due to S pneumoniae, H influenzae, and N meningitidis from Jan 1, 2018, to May, 31, 2020, as part of the Invasive Respiratory Infection Surveillance (IRIS) Initiative. Read More

BMC Infect Dis 2021 May 27;21(1):488. Epub 2021 May 27.

Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka.

Background: Leptospirosis is a zoonotic illness caused by pathogenic spirochetes of the genus Leptospira. The disease spectrum ranges from a mild influenza-like presentation to a more serious Weil's syndrome. Leptospirosis rarely presents as a primary neurological syndrome. Read More

J Vet Diagn Invest 2021 May 27:10406387211015294. Epub 2021 May 27.

Department of Paraclinical Sciences, University of Pretoria, Onderstepoort, South Africa.

Rift Valley fever (RVF) is a zoonotic, viral, mosquito-borne disease that causes considerable morbidity and mortality in humans and livestock in Africa and the Arabian Peninsula. In June 2018, 4 alpaca inoculated subcutaneously with live attenuated RVF virus (RVFV) Smithburn strain exhibited pyrexia, aberrant vocalization, anorexia, neurologic signs, and respiratory distress. One animal died the evening of inoculation, and 2 at ~20 d post-inoculation. Read More

Sci Rep 2021 May 25;11(1):10906. Epub 2021 May 25.

Department of Neurology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.

We evaluated the association between hyponatremia and tuberculous meningitis (TBM) with the aim of providing additional information for differential diagnosis from other types of infectious meningitis, especially viral meningitis (VM). Cross-sectional and longitudinal data involving 5026 participants older than 18 years were analyzed in the total population and a propensity-matched population. The initial and lowest sodium levels and longitudinal changes in TBM, bacterial meningitis (BM), and VM patients were compared. Read More

Med Mycol Case Rep 2021 Jun 4;32:84-87. Epub 2021 May 4.

Infectious Diseases Department, APHP, Saint-Louis Hospital, Paris, France.

Cryptococcosis is the third most common invasive fungal infection in solid organ transplant recipients. We describe three cases of neuro-meningeal cryptococcosis occurring among kidney transplant (KT) patients, and discuss the diagnostic and therapeutic challenges in this context. Median time from KT to infection was 6 months [range: 3-9]. Read More

Trop Med Health 2021 May 21;49(1):42. Epub 2021 May 21.

Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.

Background: Laboratory facilities for etiological diagnosis of central nervous system (CNS) infection are limited in developing countries; therefore, patients are treated empirically, and the epidemiology of the pathogens is not well-known. Tubercular meningitis is one of the common causes of meningitis, which has high morbidity and mortality, but lacks sensitive diagnostic assays. The objectives of this study were to determine the causes of meningitis in adult patients by using molecular assays, to assess the risk factors associated with them, and to explore whether biomarkers can differentiate tubercular meningitis from bacterial meningitis. Read More

Am J Transl Res 2021 15;13(4):2581-2589. Epub 2021 Apr 15.

Department of Neurology, The First People's Hospital of Wenling Wenling 317500, Zhejiang, China.

Objective: To investigate the value of the combined detection of lactate dehydrogenase (LDH), β2-transferrin (β-2Tf), and interleukin-10 (IL-10) for identification of acute intracranial infections such as meningitis.

Methods: A total of 103 patients were placed in the suppurative meningitis group (SMG), 124 patients in the viral meningitis group (VMG). Another 86 patients without any infectious diseases of the central nervous system constituted the control group (CG). Read More

Clin Microbiol Infect 2021 May 17. Epub 2021 May 17.

Region Västra Götaland, Sahlgrenska University Hospital, Department of Infectious Diseases, Gothenburg, Sweden; Institute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden.

Objectives: In central nervous system infections, early and correct management is of utmost importance. Rapid syndromic panel testing can potentially provide valuable guidance. The FilmArray meningitis/encephalitis (ME) panel detects 14 pathogens through multiplex PCR. Read More

BMJ Glob Health 2021 May;6(Suppl 2)

Essential Medicines and Health Products, Organisation Mondiale de la Sante, Geneve, Switzerland.

Vaccine licensure requires a very high safety standard and vaccines routinely used are very safe. Vaccine safety monitoring prelicensure and postlicensure enables continual assessment to ensure the benefits outweigh the risks and, when safety problems arise, they are quickly identified, characterised and further problems prevented when possible. We review five vaccine safety case studies: (1) dengue vaccine and enhanced dengue disease, (2) pandemic influenza vaccine and narcolepsy, (3) rotavirus vaccine and intussusception, (4) human papillomavirus vaccine and postural orthostatic tachycardia syndrome and complex regional pain syndrome, and (5) RTS,S/adjuvant system 01 malaria vaccine and meningitis, cerebral malaria, female mortality and rebound severe malaria. Read More

Cureus 2021 Apr 17;13(4):e14535. Epub 2021 Apr 17.

Emergency Medicine, Providence St. Mary Medical Center, Walla Walla, USA.

Aseptic viral meningitis is the most common cause of meningitis in the United States. Most cases of herpes simplex virus meningitis are caused by herpes simplex virus type 2 (HSV-2), with HSV-1 primarily causing viral encephalitis. In this report, we present a case of aseptic meningitis generated by the HSV-2 in an immunosuppressed 35-year-old female with a recent diagnosis of genital herpes that was left untreated due to reported side effects of medication. Read More

BMC Pediatr 2021 05 18;21(1):238. Epub 2021 May 18.

Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, MO, USA.

Background: Fever is a common symptom in children presenting to the Emergency Department (ED). We aimed to describe the epidemiology of systemic viral infections and their predictive values for excluding serious bacterial infections (SBIs), including bacteremia, meningitis and urinary tract infections (UTIs) in children presenting to the ED with suspected systemic infections.

Methods: We enrolled children who presented to the ED with suspected systemic infections who had blood cultures obtained at seven healthcare facilities. Read More

IDCases 2021 10;24:e01066. Epub 2021 Mar 10.

Department of Internal Medicine, Abrazo Arrowhead Hospital, Glendale, AZ 85308, United States.

West Nile Virus (WNV) is the most common mosquito-borne virus in the United States and North America. Although WNV disease occurs on a spectrum ranging from a relatively benign febrile illness to life-threatening neuroinvasive disease, the clinical presentations can vary widely and thus necessitates a high degree of suspicion. Here we describe three such cases where each individual presented with a unique constellation of symptoms that made the diagnosis challenging. Read More

Cureus 2021 Apr 13;13(4):e14454. Epub 2021 Apr 13.

Internal Medicine, Citrus Memorial Hospital, Inverness, USA.

Drug-induced aseptic meningitis is a rare entity. Diagnosis of drug-induced aseptic meningitis can be challenging due to the difficulty in distinguishing clinical presentation from bacterial or viral meningitis. We present a case of a 52-year-old Caucasian female patient who presented to the emergency room on two different occasions with severe headache, neck pain, and confusion. Read More

Pediatr Infect Dis J 2021 May 7. Epub 2021 May 7.

From the Department of Pediatrics, Hallym University College of Medicine, Kangdong Sacred Heart Hospital, Gangdong-gu, Seoul, Republic of Korea.

Background: Studies evaluating the epidemiology of pediatric meningitis are limited in our region. This study aimed to describe recent trends in the incidence of pediatric meningitis.

Methods: We estimated national trends in hospitalization rates for pediatric meningitis (<18 years) by analyzing data from the Health Insurance Review and Assessment database between 2010 and 2018. Read More

PLoS One 2021 14;16(5):e0251494. Epub 2021 May 14.

Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.

Encephalitis and meningitis (EM) are severe infections of the central nervous system associated with high morbidity and mortality. The etiology of EM in Kazakhstan is not clearly defined, so from February 1, 2017 to January 31, 2018 we conducted hospital-based syndromic surveillance for EM at the Shymkent City Hospital, in the South Kazakhstan region. All consenting inpatients meeting a standard case definition were enrolled. Read More

Eur J Clin Microbiol Infect Dis 2021 May 13. Epub 2021 May 13.

Service of Microbiology, Hospital Universitario Central de Asturias (HUCA) and Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.

Enteroviruses (EV) have been linked to lymphocytic meningitis and exanthems, but they may also be involved in acute gastroenteritis (AGE), a condition whose aetiological agent often remains unidentified. In this work 1214 samples from individuals with AGE were studied with the aim of establishing the incidence of EV. The samples were collected between September and December in three different years and subjected to real-time genomic amplification in order to determine the viral load (VL). Read More

J Infect Dis 2021 May 11. Epub 2021 May 11.

Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.

Background: Infection with varicella zoster virus (VZV) may involve different central nervous system (CNS) manifestations, including meningitis, encephalitis, and vasculitis. In cases where otherwise healthy individuals are affected, an inborn error of immunity may underlie increased susceptibility or severity of infection.

Methods: We collected a cohort of 17 adults who experienced VZV encephalitis and performed whole exome sequencing. Read More

Rinsho Ketsueki 2021 ;62(4):251-256

Department of Hematology, Oita University Hospital.

A 65-year-old woman received bone marrow transplantation from an HLA-DRB1 one locus mismatched donor for high-risk myelodysplastic syndrome. On day 237 after transplantation, she developed recurrent acute gastrointestinal graft-versus-host disease and adenoviral hemorrhagic cystitis. Hence, the methylprednisolone (mPSL) dose was increased to 2 mg/kg, and mesenchymal stem cells were administered. Read More