الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Meningitis is a serious communicable disease that is endemic in Egypt. Aseptic meningitis is defined as a syndrome with acute onset of meningeal symptoms, fever and cerebrospinal fluid pleocytosis with negative bacterial cultures. Viral meningitis is the most common type of meningitis. Enteroviruses are the most common cause of viral meningitis in all ages accounting for more than 85% of cases.
The diagnosis of enteroviral meningitis presents a challenge for the clinician. CSF examination by reverse transcriptase polymerase chain reaction for enteroviruses is a useful and efficient technique for rapid diagnosis of enteroviral meningitis. It can reduce the need for further investigations, number of medications prescribed, and length of hospital stay.
We aimed to detect the role of EV among cases of aseptic meningitis and assess clinical and biochemical analyses versus molecular assay for rapid detection of EV meningitis.
A prospective cohort study was conducted for all patients with clinically suspected meningitis, who underwent a lumbar puncture between May 2017 and December 2018 in El Shatby University and Alexandria Fever hospitals. Cytological, microbiological and biochemical examinations were done and clinical manifestations were reviewed. Molecular detection of EV was done using One-step Reverse transcriptase PCR. Pan (universal) primers selected from the highly conserved regions of the 5′ non-coding region of the genome were used.
Out of 2519 patients, 994 (40%) were found to have positive CSF findings with 716 (72%) having findings of aseptic meningitis.
Aseptic meningitis cases were equally distributed during spring, summer and autumn while the majority of bacterial meningitis cases occurred in winter.
Among bacterial meningitis cases, bacterial etiology could be detected in only 68% of cases. The predominant organisms were klebsiella spp. (17%), pneumococci (13%) and staphylococci spp. (10%).
Ninety four included samples were randomly selected from aseptic meningitis cases and were divided across 4 age groups: 13.8% neonates, 20.2% infants, 56.4% children and 9.5% adults.
Significant difference was found between different age groups as regards fever, vomiting, headache, signs of meningeal irritation, cranial nerve affection and focal neurological deficits being more common in adults (P≤ 0.05).
Among aseptic meningitis patients, adults had a higher mean CSF protein and LDH levels than children, infants and neonates while no difference was found between the 4 age groups regarding total CSF WBCs count, lymphocytes, PMNLs percentage and CSF glucose.