Takeshima Shinichi, Neshige Shuichiro, Himeno Takahiro, Hara Naoyuki, Yoshimoto Takeshi, Takamatsu Kazuhiro, Takao Shinichi, Kuriyama Masaru
Department of Neurology, Brain Attack Center, Ota Memorial Hospital.
Rinsho Shinkeigaku. 2014;54(10):791-7. doi: 10.5692/clinicalneurol.54.791.
From summer to autumn, we noted the occurrence of a small epidemic of aseptic meningitis in adults. Over the last 10 years, we have encountered 203 male (mean age, 34.6 ± 15.0 years) and 157 female (mean age, 35.6 ± 16.3 years) patients with aseptic meningitis. We could identify the causative virus in 17 (81%) of 21 cases during the abovementioned months in 2012. Identification rates of the virus in the stool, cerebrospinal fluid, throat swab, and serum samples were 71%, 67%, 42%, and 5%, respectively. The etiological viruses included enteroviruses in all cases, such as echovirus type 9 (E9) in 9 cases, echovirus type 6 (E6) in 4 cases, coxsackievirus type A9 in 1 case, and unknown type of enterovirus in 3 cases. No differences in the clinical manifestations and laboratory findings were noted between E9 meningitis and E6 meningitis. In addition, we countered 14 cases of mumps meningitis, 7 cases of varicella-zoster virus meningitis and 6 cases of herpes simplex meningitis during the last 10 years; these cases did not occur as an epidemic, but occurred sporadically. Cases of mumps meningitis were noted in all seasons, and cases of varicella-zoster virus meningitis were only noted from summer to winter. The etiology of epidemic aseptic meningitis in adults could be mainly due to enterovirus infection, and its prognosis was benign.
从夏季到秋季，我们注意到成人中出现了小规模的无菌性脑膜炎疫情。在过去10年中，我们遇到了203例男性（平均年龄34.6±15.0岁）和157例女性（平均年龄35.6±16.3岁）无菌性脑膜炎患者。在2012年上述月份的21例病例中，我们能够确定17例（81%）的致病病毒。病毒在粪便、脑脊液、咽拭子和血清样本中的检出率分别为71%、67%、42%和5%。所有病例的病原病毒均为肠道病毒，如9型艾柯病毒（E9）9例、6型艾柯病毒（E6）4例、A9型柯萨奇病毒1例、未知型肠道病毒3例。E9脑膜炎和E6脑膜炎在临床表现和实验室检查结果上无差异。此外，在过去10年中，我们还遇到了14例腮腺炎脑膜炎、7例水痘-带状疱疹病毒脑膜炎和6例单纯疱疹脑膜炎；这些病例并非以疫情形式出现，而是散发性发生。腮腺炎脑膜炎病例在所有季节均有记录，水痘-带状疱疹病毒脑膜炎病例仅在夏季至冬季有记录。成人流行性无菌性脑膜炎的病因可能主要是肠道病毒感染，其预后良好。
