During summer months, children with viral meningitis (VM) are routinely admitted to the hospital for several days for parenteral antibiotics pending bacterial/viral cultures. A more rapid diagnostic test could decrease resulting costs, inconvenience, and morbidity, provided sensitivity does not decline.

We performed viral and bacterial cultures, as well as Enterovirus (EV) Polymerase Chain Reaction (PCR), on CSF from 57 children with clinical and laboratory evidence for meningitis during the summer of 1995. Five of 57 patients had confirmed or probable bacterial meningitis and were excluded. The 52 remaining patients, ages 7 days to 15 years, had presumed VM, with mean days in hospital of 3.9. All patients had pleocytosis. Mean CSF cell count, glucose, and protein were 281, 50, and 55. CSF viral culture was positive for EV in 32/52 (61%) after a mean of 5.2 days. Twenty three of these 32 (72%) were also positive by PCR, with 3 negative and 6 indeterminate. Overall, 65% of CSFs were positive by PCR (p=0.83). Eleven CSF culture negative patients had positive EV PCR, most likely true positives based on pleocytosis ± isolation of EV from stool.

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