Clinical and Laboratory Findings That Differentiate Herpes Simplex Virus Central Nervous System Disease from Enteroviral Meningitis
Table 3
Subgroup analysis comparing demographic and clinical characteristics and investigations between patients with confirmed HSV and confirmed EnV ().
Total (%)
value
HSV ()
EnV ()
Demographics
Mean age ± SD
43.9 ± 18.4
13.1 ± 9.0
<0.001
Female
21 (72.4)
5 (26.3)
0.002
Admitted
29 (100)
17 (89.5)
0.152
Returned to emergency department <2 weeks
5 (17.2)
3 (15.8)
1.000
Immunocompromised
6 (15.0)
9 (7.1)
0.201
History
Headache ( (25,16))
24 (96.0)
16 (100)
1.000
Nausea/vomiting ( (26,17))
17 (65.4)
12 (70.6)
0.722
Altered mental status
12 (41.4)
1 (5.6)
0.008
Neck pain ( (23,16))
17 (73.9)
13 (81.3)
0.711
Photophobia ( (17,13))
10 (58.8)
6 (46.2)
0.491
Seizure
6 (21.4)
1 (5.3)
0.215
Physical exam
Neurological deficit
10 (35.7)
1 (5.3)
0.032
Rash
3 (10.3)
8 (42.1)
0.016
Nuchal rigidity, pain with flexion ( (24,18))
14 (58.3)
9 (50.0)
0.591
Mean systolic blood pressure (SD)
127.7 (17.6)
116.7 (15.2)
0.031
Mean diastolic blood pressure (SD)
75.3 (14.3)
67.3 (13.7)
0.068
Mean heart rate (SD)
96.9 (20.0)
99.1 (29.0)
0.775
Mean respiratory rate (SD)
19.0 (5.1)
22.1 (10.3)
0.244
Mean temperature (SD)
37.5 (1.2)
37.8 (1.10)
0.374
Investigations
CT head abnormal
3 (10.3)
0 (0)
<0.001
MRI brain abnormal
9 (32.1)
1 (5.3)
0.031
EEG abnormal
2 (6.9)
1 (5.3)
0.224
CSF analysis (median, IQR)
RBC (×106/L)
5.0 (1.0–13.0)
9.0 (3.0–14.0)
0.386
WBC (×106/L)
207.0 (39.0–403.0)
150.0 (42.0–365.0)
0.697
% neutrophils
3.5 (0.0–0.08)
20.0 (3.0–70.0)
0.004
% lymphocytes
87.0 (71.0–94.0)
55.0 (30.0–73.0)
0.001
% monocytes
8.0 (4.0–19.0)
11.5 (7.0–20.0)
0.444
Glucose (mmol/L)
3.3 (2.8–4.9)
3.3 (2.6–3.3)
0.141
Protein (g/L)
0.7 (0.6–1)
0.4 (0.3–0.7)
0.001
Data presented as (%) or mean ± SD (standard deviation). identifies where frequency is <166, as information was not documented. EnV: enterovirus, HSV: herpes simplex virus.
