Purpose: To evaluate the characteristics of enteroviral meningitis in panamanian children and try to predict this etiology based on a comparison of clinical and laboratory findings between patients with positive and negative polymerase chain reaction (PCR) testing of cerebrospinal flu id (CSF). Design: A retrospective review of 86 patients managed at the Hospital del Niño between october 1998 and december 1999. Diagnosis of enteroviral meningitis was performed using the PCR technique . Results: Sixty-one subjects (71%) had a positive PCR and were compared to the 25 children with non-enteroviral meningitis. No statistically significant differences were found on age, sex, temperature and morbidity score at admission between positive and negative patients. A greater percentage of patients with enteroviral meningitis had more than two vomits in the 24 hours before admission (75% vs 48%, p=0.01). The probability of having more than two vomits was 3 times greater in patients with enteroviral meningitis (OR 3.32,1. 13-9.94) than in the others. Fever on admission was more common in patients with nonenteroviral meningitis as compared with enteroviruspositive children (28% vs 8%, p=0.03; OR 0.23, 0.05-0.94). None of the laboratory and CSF findings was predictive of enteroviral etiology in this study. Conclusion: lt is not possible to predictthe enteroviral etiology of aseptic meningitis by clinical, laboratory, and CSF analysis. Thus, the use of PCR represents a fast and reliable method for diagnosis, potentially reducing the necessity of hospitalization and the use of antibiotics for management of meningitis in children.
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