Meningoencephalitis: Infectious etiology in pediatric patients at a reference hospital

Abstract

Background: The etiologies of meningoencephalitis, meningitis, or encephalitis may be infectious or non-infectious. For the microbiological diagnosis, it is necessary to perform cultures and molecular tests. The objective of this study was to describe the infectious causes of meningoencephalitis and their clinical presentation. Methods: A cross-sectional study was performed at the Hospital Civil de Guadalajara Dr. Juan I. Menchaca. Patients older than 28 days of life with meningitis, encephalitis, or meningoencephalitis syndrome were included in the study. Infectious etiology was identified through cultures, Gram stains, and molecular tests of cerebrospinal fluid (CSF). The characteristics of patients with and without an etiological diagnosis were compared. Results: Fifty patients with meningoencephalitis (n = 25), meningitis (n = 19), or encephalitis (n = 6) were included in the study. The mean age was 1 year and 62% were male. An infectious etiological diagnosis was performed in 42%; 65.2% (n = 15) were viruses and 34.8% (n = 8) bacteria. In patients with etiological diagnosis, a higher number of leukocytes were found in CSF (92 leu/mm 3 vs. 12 leu/mm 3 , p = 0.001); the history of gastroenteritis was more frequent (odds ratio [OR]: 3.5; 95% confidence interval (CI): 1.007-12.1; p = 0.04), and on examination, neck stiffness was more common (OR: 3.8; 95% CI: 1-15.2; p = 0.04). Conclusions: 42% of the patients with meningitis, encephalitis, or meningoencephalitis had an infectious etiological diagnosis; the most frequent cause was Enterovirus.