Central nervous system laboratory-confirmed influenza meningo-encephalitis treated with peramivir

Respiratory virus-related meningoencephalitis in adults

Purpose

Respiratory viruses (RVs) are pathogens that can cause central nervous system (CNS) infection, but previous research has been limited to a pediatric population. In recent years, several cases of adult RV meningoencephalitis have begun to be reported. We decided to research the CNS infection of RV in the entire neuroinfection registry.

Methods

We retrospectively reviewed the neurologic infection registry of Seoul National University (Seoul, Korea). Among a total of 661 patients in the registry, 10 adult patients were diagnosed with RV-related meningoencephalitis on RV multiplex polymerase chain reaction (PCR) screening test. We analyzed the clinical presentation, laboratory findings, and clinical course of the 10 patients.

Results

Three patients were definite RV meningoencephalitis who had positive PCR results from cerebrospinal fluid. The other seven patients were diagnosed with probable RV meningoencephalitis if they had positive PCR results in the sputum and negative results in other extensive workup.

Conclusion

RV-related meningoencephalitis should be considered a possible etiology in adult meningoencephalitis patients. To diagnose these viruses, screening test of RV PCR is recommended even in patients without upper respiratory infection symptoms.