viral meningitis, symptoms, diagnosis, differential diagnosis of meningitis


Among numerous viral meningitises from 80% to 90% of cases are accounted for meningitis of enteroviral etiology according to the international data. Despite the favorable disease course, there are forms which are characterized by severe damage of CNS. In order to improve diagnostics of enteroviral meningitis in this article we have made a comparative analysis of clinical and laboratory parameters in 23 patients with enteroviral meningitis and 18 patients with serous meningitis of non-enteroviral etiology.

Anamnesis data and the major clinical manifestations of the disease dynamics were analyzed. Particular attention is paid to the comparison of diagnoses, by which patients were sent to infectious hospital, the symptoms that occurred during patients’ admission into hospitals and their severity. The presence and severity of meningeal symptoms and the indices of cerebrospinal fluid in the patients of the comparison group were analyzed in detail.

It is shown that enteroviruses are the important factor in the development of meningitis in the children of younger age. The clinical picture of enteroviral meningitis often develops gradually for 2-3 days and includes the typical syndromes: intoxication and meningeal ones. Every third patient with enterovirus infection has diarrhea and catarrhal symptoms, that’s why it is difficult to diagnose meningitis in its early stages, but it allows to assume enteroviral etiology of the disease. The meningitis of enteroviral etiology is characterized by multiple meningeal signs, while the non-enteroviral meningitis is characterized by dissociation with the prevalence of the of Kernig’s and Brudzinski’s symptoms.

The analysis of the laboratory data showed that the enteroviral meningitis is characterized by low (over 50-100 cells) "mixed" pleocytosis (the ratio of lymphocytes and neutrophils is about 1:1).

These data can be used for differential diagnosis between enteroviral meningitis and serous meningitis of non-enteroviral etiology. 


Sorokina, M.N. & Skripchenko, N.V. (2004). Virusnye entsefality i meningity u detei: rukovodstvo dlya vrachei [Viral encephalitis and meningitis in children: guide for physicians]. Moskva: Meditsyna [in Russia].

El Hiar R. Enteroviral central nervous system infections in children of the region of monastir, Tunisia: diagnosis, laboratory findings of cerebrospinal fluid and clinical manifestations / El Hiar R., Haddad S., Jaïdane H., Hober D., Ben M'hadheb-Gharbi M., Gullberg M., Neji-Guediche M., Lindberg A.M., Gharbi J., Aouni M. // Indian J Virol. – 2012 Dec. - № 23(3). – Р. 294-302.

Papadakis G. Detection and genotyping of enteroviruses in cerebrospinal fluid in patients in Victoria, Australia, 2007-2013 / Papadakis G., Chibo D., Druce J., Catton M., Birch C. // J Med Virol. 2014 Jan 29. doi: 10.1002/jmv.23885. [Epub ahead of print].

Marri, D. (2006). Infektsionnyye bolezni u detey [Infectious diseases in children ]. Moskva: Praktika [in Russia]

March B. Epidemiology of enteroviral meningoencephalitis in neonates and young infants / March B., Eastwood K., Wright I.M., Tilbrook L., Durrheim D.N. // J Paediatr Child Health. 2013 Dec 23. doi: 10.1111/jpc.12468. [Epub ahead of print].

Shevtsova, N.P., Golubeva, M.V., Pogorelova, L.V., Masiians, V.G. (2002). Osobennosti enterovirusnykh meningitov u detei [Particulari enterovirus meningitis in children]. Aktual’nyye voprosy infektsionnoi patologii u detey . Materialy kongressa [Topical issues of infectious diseases in children. Material congress]. Moskva, 213 [in Russia].

Uchaykin, G.F., Protasenya, I.I., Reznik, V.I. Enterovirusnyi meningit u detey Chabarovska v kontse XX stoletiya [Enterovirus meningitis in children Khabarovsk in the late XX centery]. Epidemiologiya I infektsionnyye bolezni [Epidemiology and infectious diseases]№ 2, 42-46.

Korhenevich A.V. The clinic-laboratory characteristics of children enterovirus meningitis/ E.V. Michaylova, I.G. Eremeeva, A.V. Korzhenovich// 4th World Congress of the World Society for Pediatric Infectius Diseases (WSPID). – Warsaw. Poland, 2005. – P. 106.

Shchukina, A.P. & Kosintseva, U.P (2006). Klinico-immunologicheskaia characteristica serosnych meningitov enterovirusnoi etiologii [Clinical and immunological characteristics serous meningitis enterovirus etiology]. Vestnik Rossiiskogo gosudarstvennogo meditsinskogo universiteta – Herald of Russian State Medical University, T.2 , 312.

Nakaz MOZ Ukrainy № 354 vid 09.07.2004[Orders MH of Ukraine №354 from 09.07.2004] «Pro zatverdzhennia Protokoliv diagnostyky ta likuvannia infektsiynyh chvorob» [Approval of diagnostic protocols and treatment of infectious diseases].

How to Cite

Usacheva OV, Mironova KS, Firyulina OM, Syvolap VK. MODERN CLINICAL AND LABORATORY FEATURES OF ENTEROVIRAL MENINGITIS. Pathologia [Internet]. 2014Jun.18 [cited 2024Mar.2];(1). Available from:



Original research