| 1997년 여름에 유행한 성인 장바이러스성 뇌막염 |
| 최휘철, 송홍기· 고임석· 김형철· 김현석· 이병철 |
| 한림대학교 의과대학 신경과학교실 |
| Outbreak of Enteroviral Meningitis in Adults during Summer, 1997 |
| Hwi-Chul Choi, M.D., Hong-Ki Song, M.D., Im-Seok Koh, M.D.,
Hyoung-Cheol Kim, M.D., Hyun-Seok Kim, M.D., Byung-Chul Lee, M.D. |
| Department of Neurology Hallym University College of Medicine |
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| Abstract |
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Background : During a through surveillance of infections in the central nervous system, we noted an outbreak of aseptic meningitis in the summer of 1997. Methods : Medical records of 372 patients with aseptic meningitis admitted between May, 1997 and Aug, 1997 were reviewed. Polymerase chain reaction for enterovirus with cerebrospinal fluid(CSF) specimen were performed in 162 patients. Among them, enterovirus was isolated in 116 patients(71.6%). We analyzed clinical manifestations, courses, and laboratory findings including routine CSF and virus culture study of those patients(mean age: 25.3 years; m:f = 1.03:1). Results : The clinical symptoms were headache(100%), nausea(92.2%), fever(88.8%), vomiting(67.2%), myalgia(47.4%), sore throat(20.6%), abdominal pain(9.5%), diarrhea(6.9%), dizziness(4.3%), rhinorrhea(4.3%), back pain(2.6%) and meningeal irritation signs were shown in 75 patients(64.7%). There was wide variation in the number of leukocytes from 10 to 630/mm3 in the CSF. CSF total protein ranged from 14 to142mg/dL(mean : 56.3), and CSF sugar was normal in most specimens. Enteroviral subtypes were echovirus 30 in 27(23.3%) and coxsackie B virus in 12 (10.3%) patients. Hospital stay ranged 2 to 15 days(mean: 4.6) and all of them discharged without any sequelae. Conclusions : We found that the most common pathogen of aseptic meningitis prevailed in the summer of 1997 was enterovirus and its subtypes were echovirus 30 and coxsackie B virus. The disease was mild and self-limited without death or any significant complications. Enterovirus isolation from CSF can substantially establish the diagnosis and the subsequent management, therefore, early discharge is expectable.
Key words : Aseptic meningitis, Enterovirus, Outbreak |
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