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Published on: July 24, 2016
Viral aetiology of acute central nervous system infections in children, Iran
Maryam Khalili1, Hamid Rahimi Hajiabadi2, Mojtaba Akbari3
1Department of Bacteriology and Virology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Viral central nervous system (CNS) infections are common in Iranian children. Enteroviruses and herpes simplex virus (HSV) were the most frequent causes, highlighting the need for molecular diagnostics in pediatric CNS infections.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neuroscience
Background:
- Viral infections represent a significant cause of central nervous system (CNS) complications.
- A comprehensive understanding of viral CNS infections in Iranian children was lacking.
Purpose of the Study:
- To investigate the viral etiology, clinical presentation, and epidemiological characteristics of acute CNS infections in children in Iran.
- To address the knowledge gap regarding viral CNS infections in this pediatric population.
Main Methods:
- A prospective study was conducted on pediatric patients at a referral hospital in Isfahan, Iran (June 2019-June 2020).
- Multiplex PCR assays were utilized to detect viral agents in cerebrospinal fluid and respiratory/rectal swab samples.
Main Results:
- A viral etiology was confirmed or probable in 39.8% (41/103) of eligible pediatric patients.
- Enteroviruses (56.1%) and herpes simplex virus 1/2 (HSV-1/2) (31.7%) were the most prevalent viral causes.
- Infants showed a higher proportion of positive PCR results; encephalitis and meningoencephalitis were diagnosed in 68.3% and 22% of PCR-positive cases, respectively.
Conclusions:
- This study provides crucial insights into the clinical and viral etiological patterns of acute CNS infections among Iranian children.
- Molecular diagnostic methods are essential for identifying CNS viruses.
- Herpes simplex virus (HSV) and varicella-zoster virus (VZV) were identified as significant causes of encephalitis in young children.
Abstract:
Introduction. Viral infections are increasingly an important cause of central nervous system (CNS) complications.Hypothesis/Gap Statement. There is no comprehensive insight about CNS infections due to viral agents among Iranian children.Aim. This study aimed to investigate the viral aetiology, clinical and epidemiological profile of children with acute infections of the CNS.Methodology. A prospective study was conducted on children at the referral hospital in Isfahan, Iran, from June 2019 to June 2020. A multiplex PCR assay was used to detect the viral causative agent in cerebrospinal fluid and throat/rectal swab samples.Results. Among 103 patients with eligible criteria, a confirmed or probable viral aetiology was detected in 41 (39.8 %) patients, including enteroviruses - 56.1 %, herpes simplex virus 1/2 (HSV-1/2) - 31.7 %, Epstein-Barr virus - 17.1 %, varicella-zoster virus (VZV) - 9.7 %, influenza A virus (H1N1) -4.9 % and mumps - 2.4 %. There was a higher proportion of PCR-positive samples in infants than in other age groups. Encephalitis and meningoencephalitis were diagnosed in 68.3 % (28/41) and 22 % (9/41) PCR-positive cases, respectively.Conclusion. The findings of this research provide insights into the clinical and viral aetiological patterns of acute CNS infections in Iran, and the importance of molecular methods to identify CNS viruses. HSV and VZV were identified as important causes of encephalitis in young children.
