Mary Wilson
Well-known member
In Press, Journal Pre-proof What’s this?
What are journal pre-proofs?
Journal pre-proofs are Articles in Press that have been peer reviewed and accepted for publication by the Editorial Board of this publication. They have undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but are not yet definitive versions of record. These versions will undergo additional copyediting, typesetting and review, and may not yet have full ScienceDirect functionality.
Available online 24 March 2023, 105427
https://doi.org/10.1016/j.jcv.2023.105427
Nadeen Makhoul [SUP]1[/SUP], Imad Kassis [SUP]1[/SUP] [SUP]2[/SUP], Manfred S. Green [SUP]3[/SUP], Rozeen Abu Shqara [SUP]1[/SUP], Ranaa Damouni Shalabi [SUP]4[/SUP], Moran Szwarcwort Cohen [SUP]5[/SUP], Halima Dabaja-Younis [SUP]4[/SUP]
Abstract
Background
Non-polio enterovirus aseptic meningitis (NPE-AM) is a self-limiting illness that can mimic serious bacterial infection (SBI) in infants during their first months of life.
Objectives
To compare the clinical features of febrile infants diagnosed with NPE-AM with those of infants who had SBI or non-bacterial infection (NBI).
Study design
A systematic series of febrile infants < 3-months-old hospitalized between 2010-2019 with febrile illness in a tertiary hospital. Clinical and laboratory data were compared between the three groups.
Results
Overall 1278 infants were included; 207 (16.2%) had NPE-AM, 210 (16.4%) SBI and 861 (67.4%) NBI. The median age was 34 (IQR: 21.5-51.7) days. NPE-AM was documented in 25% of infants < 29 days and 9.9% of infants aged 29-90 days. Infants with NPE-AM or SBI had fever >39°C more frequently, 24.2% and 17.1% compared with 10% in infants with NBI (p<0.001). Fever duration ≥ 2 days was reported in 3.4% of infants with NPE-AM vs 18.6% in SBI and 26.3% in NBI (p<0001); rash occurred in 37.7% in NPE-AM compared to 4.6% in NBI and 5.7% in SBI (p<0.001). The mean white blood count, C-reactive protein and absolute neutrophil count were significantly lower in infants with NPE-AM compared to infants with the SBI (p<0.001) and similar to the means in infants with NBI (p=0.848, 0.098 and 0.764 respectively). A high proportion of bloody tap 346/784 (53.1%) was detected. Infants with NPE-AM were more likely to be treated with antibiotics than infants with NBIs (88.9% vs 50.7%, p<0.001), similarly to infants with SBIs (p=0.571).
Conclusions
The clinical presentation of infants with NPE-AM that could mimic bacterial infection and the high rate of bloody taps may lead to more hospital admissions and antibiotic prescriptions. Rapid molecular testing for detection of NPE may be of additional value in the evaluation of febrile infants.
https://www.sciencedirect.com/science/article/abs/pii/S1386653223000495?dgcid=rss_sd_all
What are journal pre-proofs?
Journal pre-proofs are Articles in Press that have been peer reviewed and accepted for publication by the Editorial Board of this publication. They have undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but are not yet definitive versions of record. These versions will undergo additional copyediting, typesetting and review, and may not yet have full ScienceDirect functionality.
Available online 24 March 2023, 105427
https://doi.org/10.1016/j.jcv.2023.105427
Nadeen Makhoul [SUP]1[/SUP], Imad Kassis [SUP]1[/SUP] [SUP]2[/SUP], Manfred S. Green [SUP]3[/SUP], Rozeen Abu Shqara [SUP]1[/SUP], Ranaa Damouni Shalabi [SUP]4[/SUP], Moran Szwarcwort Cohen [SUP]5[/SUP], Halima Dabaja-Younis [SUP]4[/SUP]
Abstract
Background
Non-polio enterovirus aseptic meningitis (NPE-AM) is a self-limiting illness that can mimic serious bacterial infection (SBI) in infants during their first months of life.
Objectives
To compare the clinical features of febrile infants diagnosed with NPE-AM with those of infants who had SBI or non-bacterial infection (NBI).
Study design
A systematic series of febrile infants < 3-months-old hospitalized between 2010-2019 with febrile illness in a tertiary hospital. Clinical and laboratory data were compared between the three groups.
Results
Overall 1278 infants were included; 207 (16.2%) had NPE-AM, 210 (16.4%) SBI and 861 (67.4%) NBI. The median age was 34 (IQR: 21.5-51.7) days. NPE-AM was documented in 25% of infants < 29 days and 9.9% of infants aged 29-90 days. Infants with NPE-AM or SBI had fever >39°C more frequently, 24.2% and 17.1% compared with 10% in infants with NBI (p<0.001). Fever duration ≥ 2 days was reported in 3.4% of infants with NPE-AM vs 18.6% in SBI and 26.3% in NBI (p<0001); rash occurred in 37.7% in NPE-AM compared to 4.6% in NBI and 5.7% in SBI (p<0.001). The mean white blood count, C-reactive protein and absolute neutrophil count were significantly lower in infants with NPE-AM compared to infants with the SBI (p<0.001) and similar to the means in infants with NBI (p=0.848, 0.098 and 0.764 respectively). A high proportion of bloody tap 346/784 (53.1%) was detected. Infants with NPE-AM were more likely to be treated with antibiotics than infants with NBIs (88.9% vs 50.7%, p<0.001), similarly to infants with SBIs (p=0.571).
Conclusions
The clinical presentation of infants with NPE-AM that could mimic bacterial infection and the high rate of bloody taps may lead to more hospital admissions and antibiotic prescriptions. Rapid molecular testing for detection of NPE may be of additional value in the evaluation of febrile infants.
https://www.sciencedirect.com/science/article/abs/pii/S1386653223000495?dgcid=rss_sd_all