Investigação de vírus causadores de infecções no sistema nervoso central, em pacientes pediátricos, atendidos em um hospital de referência de Belo Horizonte, Minas Gerais

Abstract

Infections in the central nervous system can be caused by viruses, bacteria, fungi, and parasites. Among viruses, various agents can be associated with complications such as meningitis and encephalitis. In Minas Gerais, between the years 2007 and 2022, 4,294 cases of viral origin were reported, of which 2,031 (47.30%) were reported in children aged zero to 14 years. Children are considered to be particularly affected, and infections in previously healthy individuals tend to be self-limiting. In most cases, the virus is not identified, compromising the generation of data related to epidemiological surveillance. Herpes simpex virus 1 and 2, varicella-zoster virus; enterovirus, dengue, Zika and other orthoflaviviruses; chikungunya and coronavirus, in 196 pediatric-origin CSF samples collected at Hospital Infantil João Paulo II between 2022 and 2023. Viral genetic material was sought through qPCR or RT- qPCR. There were 10 positive results for the presence of ENTV. There were no positive results for the other viruses. Epidemiological and clinical data provided in the medical records of patients who tested positive for ENTV were analyzed to understand the study population. This work builds upon previous studies, and in addition to the analyses described above, patients who tested positive for ENTV (n=23) and for DENV (n=22) between 2014 and 2019 had their medical record data collected and subjected to statistical tests. Among the signs and symptoms evaluated, a difference in the presence of convulsions was observed, as one patient with ENTV presented the condition, compared to 10 patients with DENV (p=0.0039). Regarding the hematimetric patterns evaluated between the two groups, patients with DENV showed lower values of hemoglobin, MCH, MCV, and hematocrit, and higher quantifications of RDW. Despite the differences, the values found in the two groups were within reference standards. This study emphasized the importance of enteroviruses in central nervous system infections in children, highlighting the comparison between the outcomes of infections by DENV and ENTV, which revealed significant differences in symptoms and hematogram results, pointing to the importance of further research and the use of laboratory tests as a tool for understanding pathogenesis.