Affiliations: Department of Pediatrics, School of Medicine,
Gyeongsang National University, Jinju, Korea | Gyeongsang Institute of Health Science, Jinju, Korea | Department of Neurology, Samsung Changwon Hospital,
Sungkyunkwan University School of Medicine, Changwon, Korea | Department of Laboratory Medicine, School of Medicine,
Gyeongsang National University, Jinju, Korea
Note: [] Correspondence: Dr. Chan-Hoo Park, Department of Pediatrics,
School of Medicine, Gyeongsang National University, 92 Chilam-dong, Jinju
660-751, Gyeongnam, Korea. Tel.: +82 55 750 8161; Fax: +82 55 752 9339; E-mail:
[email protected]
Abstract: The purpose of this study was to evaluate whether stool polymerase
chain reaction (PCR) has a higher clinical sensitivity for detecting
enterovirus compared with cerebrospinal fluid (CSF) PCR in pediatric patients
suspected to have enteroviral meningitis. We retrospectively reviewed 139
pediatric patients with enteroviral meningitis diagnosed in our hospital during
2010–2012. Enteroviral meningitis was diagnosed based on detection of
virus in CSF and/or stool samples in aseptic meningitis patients. Patients were
divided into definitive enteroviral meningitis (positive CSF PCR) and highly
probable enteroviral meningitis (negative CSF PCR, but positive stool PCR)
groups. The clinical characteristics of the two groups were compared to
identify the characteristics of patients with highly probable enteroviral
meningitis. We also analyzed the influence of sampling time on the PCR results
of the two specimen types. Patients with highly probable enteroviral meningitis
had a lower white blood cell count in CSF (P < 0.01) and a
longer latency between symptom onset and CSF sampling (P=0.03) than did
patients with definitive enteroviral meningitis. The CSF enterovirus positivity
rate was lower in CSF specimens obtained > 1 day after
clinical onset, whereas the majority of stool samples were PCR positive
throughout the course of the disease. Our results suggest that PCR of stool
specimens may be useful in pediatric patients with suspected enteroviral
meningitis, particularly when the duration of symptoms is >
1 day and/or a lower degree of CSF pleocytosis is observed.
