Dommergues M-A, Harzic M, Gobert M-E, Landre C, De Truchis A, Charara O, Foucaud P
Service de pédiatrie néonatologie, hôpital André-Mignot, centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France.
Arch Pediatr. 2007 Aug;14(8):964-70. doi: 10.1016/j.arcped.2007.03.030. Epub 2007 May 23.
To describe the clinical and biological characteristics of children presenting with enteroviral (EV) meningitis in a French paediatric unit during summer 2005.
Retrospective study of children with EV meningitis from May to September 2005, diagnosed by PCR and/or viral culture in cerebrospinal fluid (CSF), serum or throat.
We reported 99 cases of EV meningitis (96 confirmed and 3 probable). The sex ratio was 2/1, and the median age was 5 years. Peak incidence was reached during the second week of July. The predominant symptom was meningism. ENT (16%), digestive (10%), cutaneous (15%) or respiratory (4%) symptoms were rare. Blood leucocyte count found a predominance of neutrophils (73%), and lymphopenia in half of the children. The mean value of CRP was 25,5 mg/l. The median leukocyte count in CSF was 65 cells/mm(3), with a prevalence of neutrophils in 60% of cases. Pleiocytosis was absent in 20 children. CSF protein level was increased in 20% of cases. The rate of hospitalization was 57,5%. Intravenous antibiotic treatment, initiated among 18 patients, was stopped in 66,6% of the cases on reception of PCR result. The latter result was obtained in 2,3 days on average.
The epidemic of 2005 EV meningitis was as widespread as that of summer 2000. Characteristics of these meningitis are strong proportion of CSF without pleiocytose and high prevalence of neutrophils in blood and CSF.
描述2005年夏季法国一家儿科病房中出现肠道病毒（EV）脑膜炎的儿童的临床和生物学特征。
对2005年5月至9月患有EV脑膜炎的儿童进行回顾性研究，通过脑脊液（CSF）、血清或咽喉部的聚合酶链反应（PCR）和/或病毒培养进行诊断。
我们报告了99例EV脑膜炎病例（96例确诊，3例可能）。男女比例为2:1，中位年龄为5岁。7月的第二周发病率达到高峰。主要症状为脑膜刺激征。耳鼻喉（16%）、消化系统（10%）、皮肤（15%）或呼吸道（4%）症状罕见。血常规显示中性粒细胞占优势（73%），半数儿童有淋巴细胞减少。CRP的平均值为25.5mg/l。脑脊液中的白细胞计数中位数为65个细胞/mm³，60%的病例中性粒细胞占优势。20名儿童无细胞数增多。20%的病例脑脊液蛋白水平升高。住院率为57.5%。18名患者开始静脉使用抗生素治疗，66.6%的病例在收到PCR结果后停药。PCR结果平均在2.3天获得。
2005年EV脑膜炎的流行与2000年夏季一样广泛。这些脑膜炎的特征是脑脊液无细胞数增多的比例高，血液和脑脊液中中性粒细胞的患病率高。
