Volume 17, Number 12—December 2011
Dispatch
Human Cardioviruses, Meningitis, and Sudden Infant Death Syndrome in Children
Table A1
Characteristics of patients with positive human cardiovirus test results, Germany*
| Sample ID | Sampling location/ date/cohort | Clinical diagnosis | Patient age/ sex | Leading symptoms | Body temperature, °C | Recent history | General medical history | Symptomatic contact person | Altered serum laboratory parameters | Lumbar puncture results | Clinical course | Virus concentration, RNA copies per mL/g specimen | Co-infections† | Main pathologic autopsy finding |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 07/03981 | Bonn/Feb 2007/ virologic routine diagnostics | Meningitis | 9 y/F | Severe frontal headache, fatigue, meningism, photosensitivity | 38.2 | Sore throat 1 wk earlier | Uneventful | None | C-reactive protein (2.1 mg/L) | Cells 582/µL (lymphocytes 368/µL, neutrophils 162/µL, monocytes 50/µL), protein 434 mg/L, glucose 58 mg/dL | Antibiosis (cefotaxime/ ceftazidime) for 14 d, improvement after 5 d, discharged healthy after 14 d | 1.14 × 104/mL CSF, 9.50 × 102/g feces | None | NA |
| VI1607 | Hamburg/ Jul 2007/ virologic routine diagnostics | Meningitis | 3 y/F | Reduced general condition, meningism, emesis | 38.1/39.6 (d 1) | Family vacation at German seaside | Uneventful | None | C-reactive protein (13 mg/L) | Cells 16/µL, protein 237 mg/L | Antibiosis (ceftriaxone) for 3 d, discharged healthy after 5 d | 9.63 × 102/mL CSF | Enterovirus ECHO30 | NA |
| 347/10 | Bonn/2010/ forensic routine diagnostics | SIDS‡ | 9 mo/M | Rigor mortis, paleness | 39.2 (rectal) | Obstructive bronchitis, gastroenteritis (rotavirus), skin infection (Staphylococcus aureus) | Preterm birth (wk 31 of pregnancy), birth weight 1,400 g, partial trisomy 6, partial monosomy 20, hypothyreosis, albinism, retrognathia, dystrophy | NA | NA | NA | NA | Below assay detection limit | Rhinovirus | Unclear cause of death, aspiration of gastric contents |
*CSF, cerebrospinal fluid; NA, not applicable; SIDS, sudden infant death syndrome.
†Fecal specimens were tested for norovirus and enteroviruses by real-time reverse transcription PCR (RT-PCR) and for rotavirus, adenovirus, and astroviruses by ELISA; CSF specimens were tested by real-time RT-PCR/PCR/nested RT-PCR for enterovirus, influenza virus, parechovirus, rhinovirus, tick-borne encephalitis virus, coronavirus, adenovirus, parvovirus, mumps, measles, and all other human paramyxoviruses and the human herpesviruses HSV1/2, varicella zoster virus, cytomegalovirus, Epstein-Barr virus, and human herpesvirus 6. Initial and follow-up serum specimens were tested for lymphocytic choriomeningitis virus by complement binding reaction. Diagnostics of bacterial pathogens included ELISA, Western blot, and PCR for Borrelia burgdorferi sensu lato and Treponoma pallidum, complement binding reaction for Leptospira spp., and standard microbiologic culture methods.
‡Because of partial trisomy 6 and monosomy 20, also classifiable as sudden unexpected death in infancy.