Cerebrospinal Fluid White Blood Cell Counts and Lactic Acid Dehydrogenase in Enterovirus Type 71 Meningitis

Abstract

An outbreak of aseptic meningitis involving 36 children is described. Enterovirus type 71, a recently recognized cause of central nervous system and systemic illness in children, was found to be the responsible agent. On initial lumbar puncture, cerebrospinal fluid (CSF) polymorphonuclear (PMN) cell predominance was seen in 64%, and greater than 200 CSF white blood cells (WBC)/mm³ was seen in 25% of these patients. Fifty-four per cent of the pa tients subjected to repeat lumbar puncture had a significant rise in the number of CSF WBC/mm³, the majority with the maintenance of a PMN cell predomi nance. The CSF white blood cell findings of individual patients did not allow for differentiation from patients concurrently seen with bacterial meningitis. Both initial and serial measurements of CSF lactic acid dehydrogenase reliably distinguished these two groups of patients.