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338. Analysis of Etiologies of Aseptic Meningitis within a Nation-Wide Hospital Network

BACKGROUND: Aseptic meningitis can be caused by an array of microorganisms, both bacterial and non-bacterial, as well as non-infectious conditions. Some etiologies of aseptic meningitis require treatment with antibiotics, antiviral, antifungals, anti-parasitic agents, immunosuppressants, and or chem...

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Autores principales: Aravagiri, Arunmozhi S, Kubomoto, Scott, Napatkamon, Ayutyanont, Wilson, Sarah, Mallela, Sudhakar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776634/
http://dx.doi.org/10.1093/ofid/ofaa439.533
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author Aravagiri, Arunmozhi S
Kubomoto, Scott
Napatkamon, Ayutyanont
Wilson, Sarah
Mallela, Sudhakar
author_facet Aravagiri, Arunmozhi S
Kubomoto, Scott
Napatkamon, Ayutyanont
Wilson, Sarah
Mallela, Sudhakar
author_sort Aravagiri, Arunmozhi S
collection PubMed
description BACKGROUND: Aseptic meningitis can be caused by an array of microorganisms, both bacterial and non-bacterial, as well as non-infectious conditions. Some etiologies of aseptic meningitis require treatment with antibiotics, antiviral, antifungals, anti-parasitic agents, immunosuppressants, and or chemotherapy. There are limited diagnostic tools for diagnosing certain types of aseptic meningitis, therefore knowing the differential causes of aseptic meningitis, and their relative percentages may assist in diagnosis. Review of the literature reveals that there are no recent studies of etiologies of aseptic meningitis in the United States (US). This is an epidemiologic study to delineate etiologies of aseptic meningitis in a large database of 185 HCA hospitals across the US. METHODS: Data was collected from January 2016 to December 2019 on all patients diagnosed with meningitis. CSF PCR studies, and CSF antibody tests were then selected for inclusion. RESULTS: Total number of encounters were 3,149 hospitalizations. Total number of individual labs analyzed was 10,613, and of these 262 etiologies were identified. 23.6% (62) of cases were due to enterovirus, 18.7% (49) due to HSV-2, 14.5% (38) due to West Nile virus, 13.7% (36) due to Varicella zoster (VZV), 10.5% (27) due to Cryptococcus. Additionally, we analyzed the rate of positive test results by region. Nationally, 9.7% of tests ordered for enterovirus were positive. In contrast, 0.5% of tests ordered for HSV 1 were positive. The southeastern United States had the highest rate of positive tests for HSV 2 (7% of tests ordered for HSV 2 were positive). The central United States had the highest rate of positive test for West Nile virus (11% of tests ordered for West Nile were positive). The northeastern region and the highest rate of positive tests for varicella zoster (18%). Table 1: Percentage of positive CSF tests (positive tests/tests ordered) [Image: see text] Table 2: Lists the number of HIV patients and transplant patients that had positive CSF PCR/serologies [Image: see text] Figure 1: Percentage of positive CSF tests in each region [Image: see text] CONCLUSION: Approximately 40% of aseptic meningitis population had treatable etiologies. A third of the Cryptococcus meningitis population had HIV. Furthermore, enteroviruses had the majority of cases within the US, which are similar to studies done in other parts of the world. DISCLOSURES: All Authors: No reported disclosures
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spelling pubmed-77766342021-01-07 338. Analysis of Etiologies of Aseptic Meningitis within a Nation-Wide Hospital Network Aravagiri, Arunmozhi S Kubomoto, Scott Napatkamon, Ayutyanont Wilson, Sarah Mallela, Sudhakar Open Forum Infect Dis Poster Abstracts BACKGROUND: Aseptic meningitis can be caused by an array of microorganisms, both bacterial and non-bacterial, as well as non-infectious conditions. Some etiologies of aseptic meningitis require treatment with antibiotics, antiviral, antifungals, anti-parasitic agents, immunosuppressants, and or chemotherapy. There are limited diagnostic tools for diagnosing certain types of aseptic meningitis, therefore knowing the differential causes of aseptic meningitis, and their relative percentages may assist in diagnosis. Review of the literature reveals that there are no recent studies of etiologies of aseptic meningitis in the United States (US). This is an epidemiologic study to delineate etiologies of aseptic meningitis in a large database of 185 HCA hospitals across the US. METHODS: Data was collected from January 2016 to December 2019 on all patients diagnosed with meningitis. CSF PCR studies, and CSF antibody tests were then selected for inclusion. RESULTS: Total number of encounters were 3,149 hospitalizations. Total number of individual labs analyzed was 10,613, and of these 262 etiologies were identified. 23.6% (62) of cases were due to enterovirus, 18.7% (49) due to HSV-2, 14.5% (38) due to West Nile virus, 13.7% (36) due to Varicella zoster (VZV), 10.5% (27) due to Cryptococcus. Additionally, we analyzed the rate of positive test results by region. Nationally, 9.7% of tests ordered for enterovirus were positive. In contrast, 0.5% of tests ordered for HSV 1 were positive. The southeastern United States had the highest rate of positive tests for HSV 2 (7% of tests ordered for HSV 2 were positive). The central United States had the highest rate of positive test for West Nile virus (11% of tests ordered for West Nile were positive). The northeastern region and the highest rate of positive tests for varicella zoster (18%). Table 1: Percentage of positive CSF tests (positive tests/tests ordered) [Image: see text] Table 2: Lists the number of HIV patients and transplant patients that had positive CSF PCR/serologies [Image: see text] Figure 1: Percentage of positive CSF tests in each region [Image: see text] CONCLUSION: Approximately 40% of aseptic meningitis population had treatable etiologies. A third of the Cryptococcus meningitis population had HIV. Furthermore, enteroviruses had the majority of cases within the US, which are similar to studies done in other parts of the world. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7776634/ http://dx.doi.org/10.1093/ofid/ofaa439.533 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Abstracts
Aravagiri, Arunmozhi S
Kubomoto, Scott
Napatkamon, Ayutyanont
Wilson, Sarah
Mallela, Sudhakar
338. Analysis of Etiologies of Aseptic Meningitis within a Nation-Wide Hospital Network
title 338. Analysis of Etiologies of Aseptic Meningitis within a Nation-Wide Hospital Network
title_full 338. Analysis of Etiologies of Aseptic Meningitis within a Nation-Wide Hospital Network
title_fullStr 338. Analysis of Etiologies of Aseptic Meningitis within a Nation-Wide Hospital Network
title_full_unstemmed 338. Analysis of Etiologies of Aseptic Meningitis within a Nation-Wide Hospital Network
title_short 338. Analysis of Etiologies of Aseptic Meningitis within a Nation-Wide Hospital Network
title_sort 338. analysis of etiologies of aseptic meningitis within a nation-wide hospital network
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776634/
http://dx.doi.org/10.1093/ofid/ofaa439.533
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