Case report: Clinical and virological characteristics of aseptic meningitis caused by a recombinant echovirus 18 in an immunocompetent adult

Jiang, Chunmei1; Xu, Zhixiang2; Li, Jin3; Zhang, Jiaqi2; Xue, Xingkui1; Jiang, Jingxia1; Jiang, Guihua1; Wang, Xisheng1; Peng, Yun2; Chen, Tian1; Liu, Zhenzhen1; Xie, Liu1; Gao, Haibin1; Liu, Yingxia2; Yang, Yang2

2023-01-12

10.3389/fmed.2022.1094347

FRONTIERS IN MEDICINE   Impact Factor & Quartile

2296-858X

Echovirus 18 has been recognized as an important causative pathogen of aseptic meningitis in young children worldwide, and echovirus 18-induced meningitis is rarely found in adults with immunocompetence. In this case study, we report the clinical and virological characteristics of aseptic meningitis caused by recombinant echovirus 18 in an adult with immunocompetence. A 31-year-old woman with immunocompetence was admitted to our hospital with fever, dizziness, severe headache, nausea, and vomiting for the past 1 day and was diagnosed with viral meningitis based on the clinical manifestations and laboratory results from cerebrospinal fluid (CSF). The patient received antiviral treatment with ribavirin and interferon as soon as the enterovirus infection was identified using qRT-PCR and was cured after 4 days. From the oropharyngeal swab and CSF samples, two echovirus 18 strains were isolated with a single nucleotide difference located at the 5 ' UTR. Phylogenetic analyses based on the VP1 gene showed that the two strains belonged to the subgenotype C2 and were clustered with sequences obtained from China after 2015, while the results from the 3D polymerase region showed that the two strains were closely related to the E30 strains. Bootscanning results using the 5 ' UTR to 2A region and the 2B to 3 ' UTR region showed that potential intertypic recombination had occurred in the 2B gene. Recombination analyses further confirmed that the two strains (echovirus 18) presented genome recombination with echovirus 30 in the nucleotide regions of the 2B gene. To the best of our knowledge, this is the first report of echovirus 18-induced meningitis in an adult with immunocompetence from mainland China, highlighting the need for close surveillance of echovirus 18 both in children and adults in the future.

aseptic meningitis echovirus 18 immunocompetent adult recombination < evolution case report

SCI

English

Corresponding

National Science and Technology Major Project[2021YFC2301803] ; Shenzhen Science and Technology Research and Development Project[JSGG20201103153802007]

General & Internal Medicine

Medicine, General & Internal

WOS:000918436500001

FRONTIERS MEDIA SA

Web of Science

1.Peoples Hosp Longhua, Dept Infect Dis, Shenzhen, Peoples R China
2.Southern Univ Sci & Technol, Shenzhen Peoples Hosp 3, Hosp 2, State Key Discipline Infect Dis,Shenzhen Key Lab P, Shenzhen, Peoples R China
3.Shenzhen Polytech, Shenzhen, Peoples R China

Jiang, Chunmei,Xu, Zhixiang,Li, Jin,et al. Case report: Clinical and virological characteristics of aseptic meningitis caused by a recombinant echovirus 18 in an immunocompetent adult[J]. FRONTIERS IN MEDICINE,2023,9.

Jiang, Chunmei.,Xu, Zhixiang.,Li, Jin.,Zhang, Jiaqi.,Xue, Xingkui.,...&Yang, Yang.(2023).Case report: Clinical and virological characteristics of aseptic meningitis caused by a recombinant echovirus 18 in an immunocompetent adult.FRONTIERS IN MEDICINE,9.

Jiang, Chunmei,et al."Case report: Clinical and virological characteristics of aseptic meningitis caused by a recombinant echovirus 18 in an immunocompetent adult".FRONTIERS IN MEDICINE 9(2023).