MEDizzy - A 9-year-old boy is brought to a pediatric emergency

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Infections and diseases 2

A 9-year-old boy is brought to a pediatric emergency department by his father. He has had 2 days of headache, neck stiffness, and photophobia and this morning had a temperature of 38.9°C (102°F). He has also had several episodes of vomiting and diarrhea overnight. A lumbar puncture is performed, which reveals pleocytosis in the cerebrospinal fluid (CSF). Which of the following is true regarding enteroviruses as a cause of aseptic meningitis?

ExplanationEnteroviruses are responsible for up to 90% of aseptic meningitis in which an etiologic agent can be identified. Symptoms are typically more severe in adults than children. Illness is more frequent in the summer and fall in temperate climates, but other causes of viral meningitis are more common in winter and spring. Cerebrospinal fluid (CSF) analysis always shows an elevated (although usually <1000 cells/μL) white blood cell count. Early, there may be a neutrophil predominance; however, this typically shifts toward lymphocyte predominance by 24 hours. CSF glucose and protein are usually normal, although the latter can sometimes be elevated. The illness is typically self-limiting, and the prognosis is excellent.