Clinical and Laboratory Findings That Differentiate Herpes Simplex Virus Central Nervous System Disease from Enteroviral Meningitis
Table 2
Comparison of demographic and clinical characteristics and investigations between patients with HSV and EnV ().
Total (%)
value
HSV ()
EnV ()
Demographics
Age (mean, SD)
40.4 (18.3)
31.3 (14.0)
0.005
Female
25 (62.5)
70 (55.6)
0.439
Admitted
40 (100)
64 (50.8)
<0.001
Returned to emergency department <2 weeks
8 (17.9)
19 (15.1)
0.467
Immunocompromised
6 (15.0)
9 (7.1)
0.201
History
Headache
35 (97.2)
122 (99.2)
0.403
Nausea/vomiting ( (36,117))
27 (75.0)
89 (75.2)
0.979
Altered mental status
18 (46.2)
4 (3.2)
<0.001
Neck pain ( (32,112))
25 (78.1)
81 (72.3)
0.511
Photophobia ( (24,106))
16 (66.7)
65 (61.3)
0.626
Seizure
8 (21.1)
2 (1.6)
<0.001
Physical exam
Neurological deficit
17 (44.7)
5 (3.9)
<0.001
Rash
6 (15.0)
18 (14.6)
0.955
Nuchal rigidity or pain with flexion ( (33,119))
19 (57.9)
58 (49.2)
0.489
Mean systolic blood pressure (SD)
129.9 (17.0)
127.2 (16.5)
0.518
Mean diastolic blood pressure (SD)
75.5 (12.8)
72.4 (11.4)
0.225
Mean heart rate (SD)
93.3 (19.0)
89.1 (19.3)
0.175
Mean respiratory rate (SD)
18.6 (4.4)
18.2 (4.8)
0.684
Mean temperature (SD)
37.5 (1.2)
37.3 (1.1)
0.388
Investigations
CT head abnormal
3 (7.5)
0 (0.0)
0.001
MRI brain abnormal
13 (33.3)
3 (2.4)
<0.001
EEG abnormal
6 (15.0)
1 (0.8)
<0.001
CSF analysis (median, IQR)
RBC (×106/L)
5.5 (1.0–16.5)
6.0 (1.0–22.0)
0.965
WBC (×106/L)
199.0 (75.0–406.0)
156.5 (51.0–420.0)
0.448
% neutrophils
3.0 (0.0–8.0)
9.5 (2.0–37.5)
0.0002
% lymphocytes
87.0 (72.0–94.0)
67.0 (40.0–87.0)
0.0004
% monocytes
7.0 (4.0–15.0)
10.0 (3.0–20.0)
0.767
Glucose (mmol/L)
3.2 (2.8–4.4)
3.1 (2.7–3.5)
0.093
Protein (g/L)
0.9 (0.6–1.2)
0.6 (0.5–0.9)
0.0005
Data presented as (%) or mean ± SD (standard deviation). identifies where frequency is <166, as information was not documented. EnV: enterovirus, HSV: herpes simplex virus.
