Evaluation of enterovirus concentration, species identification, and cerebrospinal fluid parameters in patients of different ages with aseptic meningitis in São Paulo, Brazil

Author:

Honorato Layla1ORCID,Ferreira Noely Evangelista1,Domingues Renan Barros2,Senne Carlos2,Leite Fernando Brunale Vilela de Moura2,Santos Márcio Vega dos2,Fernandes Gustavo Bruniera Peres23,Paião Heuder Gustavo Oliveira1,Vilas Boas Lucy Santos1,da Costa Antonio Charlys1,Tozetto‐Mendoza Tânia Regina1ORCID,Witkin Steven S.14,Mendes‐Correa Maria Cássia1

Affiliation:

1. Laboratory of Virology (LIM 52), Department of Infectious Diseases Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil

2. Senne Liquor Diagnóstico São Paulo Brazil

3. Clinical Laboratory Hospital Israelita Albert Einstein São Paulo Brazil

4. Department of Obstetrics and Gynecology Weill Cornel Medicine New York New York USA

Abstract

AbstractHuman enteroviruses (EV) are the most common cause of aseptic meningitis worldwide. Data on EV viral load in cerebrospinal fluid (CSF) and related epidemiological studies are scarce in Brazil. This study investigated the influence of EV viral load on CSF parameters, as well as identifying the involved species. CSF samples were collected in 2018–2019 from 140 individuals at The Hospital das Clínicas, São Paulo. The EV viral load was determined using real‐time quantitative polymerase chain reaction, while EV species were identified by 5′UTR region sequencing. Median viral load was 5.72 log10 copies/mL and did not differ by subjects' age and EV species. Pleocytosis was observed in 94.3% of cases, with the highest white blood cell (WBC) counts in younger individuals. Viral load and WBC count were correlated in children (p = 0.0172). Elevated lactate levels were observed in 60% of cases and correlated with the viral load in preteen‐teenagers (p = 0.0120) and adults (p = 0.0184). Most individuals had normal total protein levels (70.7%), with higher in preteen‐teenagers and adults (p < 0.0001). By sequencing, 8.2% were identified as EV species A and 91.8% as species B. Age‐specific variations in CSF characteristics suggest distinct inflammatory responses in each group.

Publisher

Wiley

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