The impact of cerebrospinal fluid viral analysis on empiric antibiotic use in children admitted to Tygerberg Children’s hospital with suspected meningitis
Date
2018-10
Journal Title
Journal ISSN
Volume Title
Publisher
Medpharm Publications
Abstract
Background: Viral meningitis is the most common form of aseptic meningitis and requires minimal investigation and treatment.
Polymerase chain reaction (PCR) has become the ‘gold standard’ for identifying viruses in cerebrospinal fluid and can provide
rapid results. The objective of the study was to describe the aetiology and epidemiology of viral meningitis at Tygerberg
Children’s Hospital, as well as the impact of a positive cerebral spinal fluid (CSF) viral panel on the duration of empiric
antibiotic treatment.
Methods: This was a retrospective folder review of all children aged between 29 days and 13 years who had a CSF specimen on
which a viral analysis was performed from January 1, 2010 to December 31, 2014.
Results: A total of 288 specimens were identified from the laboratory database. Seventy-nine specimens were presented for data
analysis. Thirty-seven specimens had a positive viral analysis. The median age was 11.3 months (IQR 3.7–49.16 months). The
microscopy and chemistry results were similar for the two groups except for the CSF lymphocyte count, which was
significantly higher in the group with a positive CSF viral analysis compared to those with a negative CSF viral analysis
(median 52 vs. 12 × 106/l, p = 0.005). The most common identified virus was Epstein–Barr virus (EBV) (23%), followed by
enterovirus (17%). Children with a positive viral analysis tended to receive antibiotics for longer than those who had
negative results (p = 0.223).
Conclusion: The addition of CSF viral analysis could be helpful in the management of children with meningitis, but at present
appears to have little impact on the length of antibiotic use.
Description
CITATION: Kruger, I., Maritz, J. & Finlayson, H. 2018. The impact of cerebrospinal fluid viral analysis on empiric antibiotic use in children admitted to Tygerberg Children’s hospital with suspected meningitis. Southern African Journal of Infectious Diseases, 33(4):101-105, doi:10.4102/sajid.v33i4.157.
The original publication is available at https://sajid.co.za
The original publication is available at https://sajid.co.za
Keywords
Meningitis in children -- Diagnosis, Cerebrospinal fluid -- Examination, Antibiotics, Meningitis in children -- Treatment
Citation
Kruger, I., Maritz, J. & Finlayson, H. 2018. The impact of cerebrospinal fluid viral analysis on empiric antibiotic use in children admitted to Tygerberg Children’s hospital with suspected meningitis. Southern African Journal of Infectious Diseases, 33(4):101-105, doi:10.4102/sajid.v33i4.157.