The Prevalence of Enteroviruses, Mumps virus, and Herpes Simplex Virus-1 in Cerebrospinal Fluid Samples of Children with Aseptic Meningitis

Abstract

Meningitis is defined as an inflammation of the meninges, which are the protective membranes surrounding the brain and spinal cord. Aseptic meningitis is the term used to describe all forms of meningitis that are not caused by pyogenic bacteria. Aseptic meningitis can be caused by a variety of etiological agents. Infectious agents include viruses, fungi, and parasites. Viruses are regarded as significant etiological agents of aseptic meningitis. The viral etiology of this disease exhibits variability across different age groups and countries. This study aimed to examine the prevalence of different viruses (enterovirus, mumps virus, and HSV-1) in cerebrospinal fluid (CSF) samples of children diagnosed with aseptic meningitis. A total of 58 cerebrospinal fluid (CSF) samples were obtained from patients suspected of having meningitis and admitted to Ali Asghar Hospital in Tehran during the 2019-2020 period. Nucleic acid extraction was conducted, and polymerase chain reaction (PCR) testing was performed to investigate the presence of various meningitis-causative viruses. A total of 32 patients (24 males and 8 females) were found to be infected with viruses. The most prevalent meningitis virus identified was enterovirus, accounting for 25.9% of cases (n=15). The mumps virus and herpes simplex virus (HSV) were identified in 11 (19%) and six (10.3%) patients, respectively. The most common clinical manifestations observed in children with aseptic meningitis were fever and vomiting. A statistically significant correlation was identified between term week and the occurrence of viral meningitis among patients infected with HSV and mumps (p-value = 0.04). Furthermore, a borderline relationship was observed between a history of surgery and viral meningitis. Enteroviruses represent a significant etiological agent of aseptic meningitis across a range of age groups. An accurate diagnosis of meningitis viruses, such as enteroviruses, will facilitate the implementation of appropriate and life-saving antiviral therapies, while reducing the overuse of antibiotics.

Keywords: Aseptic meningitis; CSF samples; Enteroviruses; HSV1; Mumps Virus.