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

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

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.

MeSH terms

  • Affect
  • Central Nervous System Infections* / epidemiology
  • Child
  • Cross-Sectional Studies
  • Epstein-Barr Virus Infections*
  • Herpesvirus 4, Human
  • Humans

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The study was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq (PROCAD Amazonia 88887.200582/2018–00). SM, EM, and JC received support from FAPEAM/POSGRAD. EF received support from CAPES/CNPq. VSi received support from FAPEAM/CT&I ÁREAS PRIORITÁRIAS. CB received support from FAPEAM/PAIC.