American Journal of Epidemiology Vol. 125, No. 3: 499-508
Copyright © 1987 by The Johns Hopkins University School of Hygiene and Public Health
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POSSIBLE ASSOCIATION OF MYCOPLASMA AND VIRAL RESPIRATORY INFECTIONS WITH BACTERIAL MENINGITIS
1Department of Pediatrics, Division of Infectious Diseases, University of Texas Health Science Center, Southwestern Medical School Dallas, TX
2Department of Medicine, Division of Infectious Diseases, University of Texas Health Science Center, Southwestern Medical School Dallas, TX
Reprint requests to Dr. Keith Krasinski at current address: Department of Pediatrics, New York University Medical Center, 550 First Avenue, New York, NY 10016.
The presence of viral infection was evaluated in 160 children older than three months with bacterial meningitis who were admitted to Children's Medical Center or Parkland Memorial Hospital, Dallas, TX. between October 1979 and March 1982. Results were compared with a single serologic specimen in 138 children without meningitis. A recent history of upper respiratory infection was obtained from 60% of patients, Including 10/13 with pneumococcal, 9/16 with meningococcal, and 77/131 with Haemophilus influenzae meningitis. Viral infection was documented by serologic response (23.8%) or viral isolation (13.2%) in 63/160 (40%) of patients with meningitis. There were 23 positive cultures (one patient with both adenovirus and respiratory syncytial virus). Picornaviruses, including two rhinoviruses, were isolated from six of the 24 subjects without meningitis who had viral cultures. There were 69 serologic conversions in meningitis patients, with 12 patients converting to two organisms and four patients converting to three organisms. Viral diagnoses included: adenovlrus, 32 children; respiratory syncytial virus, 14; influenza A, 8; influenza B, 4; parainfluenza (1, 2, and 3), 12; picomaviruses, 9; herpes simplex virus, 1; and cytomegalovirus, 1. Additionally, 6/15 seroconverted to Mycoplasma pneumonlae. The acute geometric mean serum antibody titers of meningitis patients were tower than those of the comparison group for adenovirus (3.5 vs. 6.6, p <0.001) and influenza B (1.2 vs. 1.6, p <0.05). Twenty nine of 131 patients with H. Influenzae had evidence of recent adenovirus infection. Primary infection with adenoviruses and possibly influenza B or mycoplasma precedes development of bacterial meningitis in some patients and may be a predisposing factor.
meningitis; Mycoplasma pneumoniae; respiratory tract infections; viruses
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