Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of aseptic meningitis

Bonita E. Lee, Rupesh Chawla, Joanne M. Langley, Sarah E. Forgie, Mohammed Al-Hosni, Krista Baerg, Entesar Husain, James Strong, Joan L. Robinson, Upton Allen, Barbara J. Law, Simon Dobson, H. Dele Davies

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Background: The seasonality, clinical and radiographic features and outcome of aseptic meningitis have been described for regional outbreaks but data from a wider geographic area is necessary to delineate the epidemiology of this condition. Methods: A retrospective chart review was completed of children presenting with aseptic meningitis to eight Canadian pediatric hospitals over a two-year period. Results: There were 233 cases of proven enteroviral (EV) meningitis, 495 cases of clinical aseptic meningitis and 74 cases of possible aseptic meningitis with most cases occurring July to October. Headache, vomiting, meningismus and photophobia were more common in children ≥ 5 years of age, while rash, diarrhea and cough were more common in children < 5 years of age. Pleocytosis was absent in 22.3% of children < 30 days of age with proven EV meningitis. Enterovirus was isolated in cerebrospinal fluid (CSF) from 154 of 389 patients (39.6%) who had viral culture performed, and a nucleic acid amplification test for enterovirus was positive in CSF from 81 of 149 patients (54.3%). Imaging of the head by computerized tomography or magnetic resonance imaging was completed in 96 cases (19.7%) and 24 had abnormal findings that were possibly related to meningitis while none had changes that were definitely related to meningitis. There was minimal morbidity and there were no deaths. Conclusion: The clinical presentation of aseptic meningitis varies with the age of the child. Absence of CSF pleocytosis is common in infants < 30 days of age. Enterovirus is the predominant isolate, but no etiologic agent is identified in the majority of cases of aseptic meningitis in Canadian children.

Original languageEnglish (US)
Article number68
JournalBMC Infectious Diseases
Volume6
DOIs
StatePublished - Apr 10 2006

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Aseptic Meningitis
Canada
Research Personnel
Pediatrics
Meningitis
Enterovirus
Infection
Cerebrospinal Fluid
Leukocytosis
Meningism
Nucleic Acid Amplification Techniques
Photophobia
Pediatric Hospitals
Exanthema
Cough
Vomiting
Disease Outbreaks
Headache
Diarrhea
Epidemiology

ASJC Scopus subject areas

  • Infectious Diseases

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Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of aseptic meningitis. / Lee, Bonita E.; Chawla, Rupesh; Langley, Joanne M.; Forgie, Sarah E.; Al-Hosni, Mohammed; Baerg, Krista; Husain, Entesar; Strong, James; Robinson, Joan L.; Allen, Upton; Law, Barbara J.; Dobson, Simon; Davies, H. Dele.

In: BMC Infectious Diseases, Vol. 6, 68, 10.04.2006.

Research output: Contribution to journalArticle

Lee, BE, Chawla, R, Langley, JM, Forgie, SE, Al-Hosni, M, Baerg, K, Husain, E, Strong, J, Robinson, JL, Allen, U, Law, BJ, Dobson, S & Davies, HD 2006, 'Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of aseptic meningitis', BMC Infectious Diseases, vol. 6, 68. https://doi.org/10.1186/1471-2334-6-68
Lee, Bonita E. ; Chawla, Rupesh ; Langley, Joanne M. ; Forgie, Sarah E. ; Al-Hosni, Mohammed ; Baerg, Krista ; Husain, Entesar ; Strong, James ; Robinson, Joan L. ; Allen, Upton ; Law, Barbara J. ; Dobson, Simon ; Davies, H. Dele. / Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of aseptic meningitis. In: BMC Infectious Diseases. 2006 ; Vol. 6.
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abstract = "Background: The seasonality, clinical and radiographic features and outcome of aseptic meningitis have been described for regional outbreaks but data from a wider geographic area is necessary to delineate the epidemiology of this condition. Methods: A retrospective chart review was completed of children presenting with aseptic meningitis to eight Canadian pediatric hospitals over a two-year period. Results: There were 233 cases of proven enteroviral (EV) meningitis, 495 cases of clinical aseptic meningitis and 74 cases of possible aseptic meningitis with most cases occurring July to October. Headache, vomiting, meningismus and photophobia were more common in children ≥ 5 years of age, while rash, diarrhea and cough were more common in children < 5 years of age. Pleocytosis was absent in 22.3{\%} of children < 30 days of age with proven EV meningitis. Enterovirus was isolated in cerebrospinal fluid (CSF) from 154 of 389 patients (39.6{\%}) who had viral culture performed, and a nucleic acid amplification test for enterovirus was positive in CSF from 81 of 149 patients (54.3{\%}). Imaging of the head by computerized tomography or magnetic resonance imaging was completed in 96 cases (19.7{\%}) and 24 had abnormal findings that were possibly related to meningitis while none had changes that were definitely related to meningitis. There was minimal morbidity and there were no deaths. Conclusion: The clinical presentation of aseptic meningitis varies with the age of the child. Absence of CSF pleocytosis is common in infants < 30 days of age. Enterovirus is the predominant isolate, but no etiologic agent is identified in the majority of cases of aseptic meningitis in Canadian children.",
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AU - Lee, Bonita E.

AU - Chawla, Rupesh

AU - Langley, Joanne M.

AU - Forgie, Sarah E.

AU - Al-Hosni, Mohammed

AU - Baerg, Krista

AU - Husain, Entesar

AU - Strong, James

AU - Robinson, Joan L.

AU - Allen, Upton

AU - Law, Barbara J.

AU - Dobson, Simon

AU - Davies, H. Dele

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N2 - Background: The seasonality, clinical and radiographic features and outcome of aseptic meningitis have been described for regional outbreaks but data from a wider geographic area is necessary to delineate the epidemiology of this condition. Methods: A retrospective chart review was completed of children presenting with aseptic meningitis to eight Canadian pediatric hospitals over a two-year period. Results: There were 233 cases of proven enteroviral (EV) meningitis, 495 cases of clinical aseptic meningitis and 74 cases of possible aseptic meningitis with most cases occurring July to October. Headache, vomiting, meningismus and photophobia were more common in children ≥ 5 years of age, while rash, diarrhea and cough were more common in children < 5 years of age. Pleocytosis was absent in 22.3% of children < 30 days of age with proven EV meningitis. Enterovirus was isolated in cerebrospinal fluid (CSF) from 154 of 389 patients (39.6%) who had viral culture performed, and a nucleic acid amplification test for enterovirus was positive in CSF from 81 of 149 patients (54.3%). Imaging of the head by computerized tomography or magnetic resonance imaging was completed in 96 cases (19.7%) and 24 had abnormal findings that were possibly related to meningitis while none had changes that were definitely related to meningitis. There was minimal morbidity and there were no deaths. Conclusion: The clinical presentation of aseptic meningitis varies with the age of the child. Absence of CSF pleocytosis is common in infants < 30 days of age. Enterovirus is the predominant isolate, but no etiologic agent is identified in the majority of cases of aseptic meningitis in Canadian children.

AB - Background: The seasonality, clinical and radiographic features and outcome of aseptic meningitis have been described for regional outbreaks but data from a wider geographic area is necessary to delineate the epidemiology of this condition. Methods: A retrospective chart review was completed of children presenting with aseptic meningitis to eight Canadian pediatric hospitals over a two-year period. Results: There were 233 cases of proven enteroviral (EV) meningitis, 495 cases of clinical aseptic meningitis and 74 cases of possible aseptic meningitis with most cases occurring July to October. Headache, vomiting, meningismus and photophobia were more common in children ≥ 5 years of age, while rash, diarrhea and cough were more common in children < 5 years of age. Pleocytosis was absent in 22.3% of children < 30 days of age with proven EV meningitis. Enterovirus was isolated in cerebrospinal fluid (CSF) from 154 of 389 patients (39.6%) who had viral culture performed, and a nucleic acid amplification test for enterovirus was positive in CSF from 81 of 149 patients (54.3%). Imaging of the head by computerized tomography or magnetic resonance imaging was completed in 96 cases (19.7%) and 24 had abnormal findings that were possibly related to meningitis while none had changes that were definitely related to meningitis. There was minimal morbidity and there were no deaths. Conclusion: The clinical presentation of aseptic meningitis varies with the age of the child. Absence of CSF pleocytosis is common in infants < 30 days of age. Enterovirus is the predominant isolate, but no etiologic agent is identified in the majority of cases of aseptic meningitis in Canadian children.

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