AUTHOR=Marinho Eveny Perlize Melo , Ferreira Ewerton da Silva , Barrionuevo Caio Cesar Leiva Bastos , Melo Sabrina Araújo , Cordeiro Jady Shayenne Mota , Pinto Sergio Damasceno , Monte Rossicleia Lins , da Silva Valderjane Aprígio , Martins Yasmin Ferreira , Reis Monique Freire , Tufic-Garutti Samantha dos Santos , Sampaio Vanderson de Souza , de Castro Daniel Barros , Feitoza Pablo Vinicius Silveira , da Rocha Lucia Alves , de Lima Ferreira Luiz Carlos , Bastos Michele de Souza 

TITLE=Pediatric central nervous system infections in the Amazon: clinical and laboratory profiles

JOURNAL=Frontiers in Public Health

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1329091

DOI=10.3389/fpubh.2023.1329091

ISSN=2296-2565

ABSTRACT=<sec id="sec1"><title>Background</title><p>Central nervous system (CNS) infections are important causes of mortality and morbidity in children, and they are related to severe problems such as hearing loss, neurological sequelae, and death. The objective was to describe clinical and laboratory exam profiles of children who were diagnosed with CNS infections.</p></sec><sec id="sec2"><title>Methods</title><p>We conducted a cross-sectional study based on medical records, which included pediatric patients aged from 3 months to 15 years, with a clinical suspicion of CNS infection between January 2014 to December 2019. The pathogens were confirmed in cerebrospinal fluid (CSF) samples using Gram staining, cell culture, molecular diagnostics (PCR and qPCR), and serology.</p></sec><sec id="sec3"><title>Results</title><p>Out of the 689 enrolled patients, 108 (15.6%) had laboratory-confirmed infections in CSF. The most common bacterial pathogens isolated from the culture were <italic>Neisseria meningitidis</italic> serogroup C in 19, <italic>Streptococcus pneumoniae</italic> in 11, and <italic>Haemophilus influenzae</italic> in seven samples. The viruses identified were <italic>Enterovirus</italic>, <italic>Cytomegalovirus</italic>, Var<italic>icella-zoster virus</italic>, <italic>Epstein–Barr virus</italic>, and arbovirus. No patient was found to be positive for <italic>Herpes simplex virus 1 and 2</italic>. Patients with viral infections showed altered levels of consciousness (<italic>p</italic> = 0.001) when compared to bacterial infections.</p></sec><sec id="sec4"><title>Conclusion</title><p>This study shows the presence of important vaccine-preventable pathogens, and different families of viruses causing CNS infections in the pediatric patients of Manaus.</p></sec>