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. 2023 Dec 21:11:1329091.
doi: 10.3389/fpubh.2023.1329091. eCollection 2023.

Pediatric central nervous system infections in the Amazon: clinical and laboratory profiles

Eveny Perlize Melo Marinho  1 , Ewerton da Silva Ferreira  1 , Caio Cesar Leiva Bastos Barrionuevo  1 , Sabrina Araújo Melo  1 , Jady Shayenne Mota Cordeiro  2 , Sergio Damasceno Pinto  3 , Rossicleia Lins Monte  3 , Valderjane Aprígio da Silva  1 , Yasmin Ferreira Martins  1 , Monique Freire Reis  4   5 , Samantha Dos Santos Tufic-Garutti  3 , Vanderson de Souza Sampaio  2 , Daniel Barros de Castro  1   6 , Pablo Vinicius Silveira Feitoza  1   3 , Lucia Alves da Rocha  1   7 , Luiz Carlos de Lima Ferreira  1 , Michele de Souza Bastos  1   3
Affiliations

Pediatric central nervous system infections in the Amazon: clinical and laboratory profiles

Eveny Perlize Melo Marinho et al. Front Public Health. .

Abstract

Background: Central nervous system (CNS) infections are important causes of mortality and morbidity in children, and they are related to severe problems such as hearing loss, neurological sequelae, and death. The objective was to describe clinical and laboratory exam profiles of children who were diagnosed with CNS infections.

Methods: We conducted a cross-sectional study based on medical records, which included pediatric patients aged from 3 months to 15 years, with a clinical suspicion of CNS infection between January 2014 to December 2019. The pathogens were confirmed in cerebrospinal fluid (CSF) samples using Gram staining, cell culture, molecular diagnostics (PCR and qPCR), and serology.

Results: Out of the 689 enrolled patients, 108 (15.6%) had laboratory-confirmed infections in CSF. The most common bacterial pathogens isolated from the culture were Neisseria meningitidis serogroup C in 19, Streptococcus pneumoniae in 11, and Haemophilus influenzae in seven samples. The viruses identified were Enterovirus, Cytomegalovirus, Varicella-zoster virus, Epstein-Barr virus, and arbovirus. No patient was found to be positive for Herpes simplex virus 1 and 2. Patients with viral infections showed altered levels of consciousness (p = 0.001) when compared to bacterial infections.

Conclusion: This study shows the presence of important vaccine-preventable pathogens, and different families of viruses causing CNS infections in the pediatric patients of Manaus.

Keywords: Brazil; adolescents; bacterial meningitis; cerebrospinal fluid; neurological infections; viral infection.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be constructed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of capture, inclusion, and exclusion according to the steps of this 108 research to compose the final sample of pediatric patients with etiological agents detected in the cerebrospinal fluid from Manaus, Amazonas, 2014–2019.
Figure 2
Figure 2
Map of the neighborhoods of the city of Manaus, and the distribution of cases confirmed with etiological agents detected in the cerebrospinal fluid from Manaus, Amazonas, 2014–2019.
Figure 3
Figure 3
Distribution of Vaccine-preventable bacterial agents isolated in cerebrospinal fluid samples by age group of pediatric patients from Manaus, Amazonas, 2014–2019.
See this image and copyright information in PMC

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