Enteroviruses (EV) are the most common etiologic agents of aseptic meningitis in infants. Rapid diagnosis of EV meningitis (EVM) by PCR can reduce unnecessary antibiotic use and hospitalization. Sensitivity and specificity of this test in a clinical setting has not been firmly established. We examined the clinical utility of this test in diagnosing EVM using CSF, serum and urine samples from infants three months of age and younger undergoing lumbar punctures (LP) for evaluation of possible meningitis. Fifty-five infants with no evidence of bacterial disease and atraumatic LP's were evaluated. Using positive CSF EV culture to define EVM, analysis showed: Table The low specificity and PPV of the test result from the inherent poor sensitivity of EV culture for detecting EVM. Alternatively, defining EVM as either positive CSF EVC or CSF pleocytosis(>32 WBC/mm3) with positive rectal/stool EVC, analysis showed:Table The findings demonstrate the clinical utility of CSF PCR in diagnosing EVM in infants. Serum and urine PCR do not add significantly to the utility but may be helpful in the diagnosis of EV disease without meningitis.

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