unusual peripheral blood-count and csf content during an outburst of echo-30 meningitis
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ELSEVIER Clinical Neurology and Neurosurgery 97 (1995) 58
Clinical Neurology and Neurosurgery
Let te r to the Ed i t o r
Unusual peripheral blood-count and CSF content outburst of Echo-30 meningitis
during an
Y. Eshel, J. Sarova -P inhas
Department of Neurology, The E. Wolfson Medical Center, Holon, Israel, and Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel
Received 24 may 1994; revised 17 October 1994; accepted 17 October 1994
Dear Sir, During the Summer of 1993, 35 patients with viral
meningitis were hospitalized in our department. This outburst was characterized by three outstanding labora- tory parameters: (1) In 26 patients, Echo-30 virus was found to be the pathogen isolated from both blood and CSF. (2) The peripheral blood count of these patients was different from the one usually seen in acute viral diseases. All the patients had leukocytosis with neutro- philia and a "shift to the left". Some patients had more than 15 000 leukocytes/mm 3 and the mean leukocyte count of the group was 12 450 + 1630, with a mean of 77% neutrophilic count. (3) The CSF of the patients contained a mean of 143 + 35 cells/mm 3 with 78% neu- trophils. When these laboratory data are compared to those of patients with viral meningitis from the Summer of 1992 and the beginning of 1994, there is a significant difference between the peripheral leukocyte count being, during 1992, 5320 + 690 cells/mm 3 with only 43% neu-
trophils. The CSF cytochemical contents did not differ, but the patients of 1993 had more marked neutrophilia in CSF: 78% vs 34% in 1994 (p = 0.007).
Echo viral meningitis outbreaks, which were described in England and the Far-East [1,2], were not accompanied by peripheral leukocytosis more than a routine viral dis- ease does.
During the beginning of the Summer of 1994 the most common pathogen was the Echo-21 virus, but no leuko- cytosis was found either in peripheral blood or CSF.
References
[1] Miwa, C. and Sawatari, S. (1993) Epidemic of aseptic meningitis with echovirus type 30 in Gifu prefecture. Kansen shogaku-Zasshi, 67:1068-1075.
[2] Gallacher, K., Ghosh, K., Patel, A. and Walker, E. (1993) An outbreak of echovirus type 4 infection and its implication for diag- nosis and management in general practice. J. Infect., 26:321 324.
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