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

Bonita E Lee1, Rupesh Chawla, Joanne M Langley

  • 1Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada. bonitlee@ualberta.ca

BMC Infectious Diseases
|April 11, 2006
PubMed

Insights

Aseptic meningitis in Canadian children, primarily caused by enterovirus (EV), shows age-dependent symptoms. Infants under 30 days often lack cerebrospinal fluid (CSF) pleocytosis, and the specific cause remains unidentified in many cases.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology

Background:

  • Aseptic meningitis epidemiology requires broader geographic data beyond regional outbreaks.
  • Understanding seasonality, clinical, and radiographic features is crucial.

Purpose of the Study:

  • To delineate the epidemiology of aseptic meningitis in Canadian children.
  • To describe clinical and radiographic features and outcomes across a wider geographic area.

Main Methods:

  • Retrospective chart review of children with aseptic meningitis across eight Canadian pediatric hospitals over two years.
  • Analysis of clinical presentation, laboratory results (CSF analysis, viral culture, nucleic acid amplification tests), and neuroimaging.

Main Results:

  • Most cases (233 proven enteroviral, 495 clinical aseptic meningitis) occurred from July to October.
  • Clinical features varied by age: older children had headache, vomiting, meningismus, photophobia; younger children had rash, diarrhea, cough.
  • Enterovirus (EV) was the predominant identified pathogen (39.6% culture, 54.3% NAAT). CSF pleocytosis was absent in 22.3% of infants <30 days with proven EV meningitis. Neuroimaging revealed few findings definitively related to meningitis. Minimal morbidity and no deaths were observed.

Conclusions:

  • Aseptic meningitis presentation in children is age-dependent.
  • Absence of CSF pleocytosis is common in infants under 30 days.
  • Enterovirus is the main identified cause, but the etiologic agent remains unknown in many pediatric cases.
Abstract

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