Recurrent Enterovirus Meningitis in Children: A Case Series from Vietnam National Children’s Hospital, 2021-2025

Abstract: Objective: To describe the epidemiological, clinical, and laboratory characteristics of recurrent enterovirus meningitis in children treated at Vietnam National Children’s Hospital from 2021 to 2025. Methods: A retrospective descriptive case series included 24 children with at least two episodes of enterovirus meningitis. Forty-nine hospital episodes were described. Results: Median age at the first episode was 4.0 years (3.0–5.5), and 66.7% were male. Twenty-three children had two episodes and one had three. The median interval from the first to the second episode was 206.5 days (138.5–453.0). A distinct seasonal pattern was observed, with most episodes occurring from April to December and a peak in October and November. No substantial differences in clinical presentation were observed between the initial and recurrent episodes. Fever, headache, vomiting, and neck stiffness remained the predominant clinical manifestations, whereas seizures and altered consciousness were uncommon. Median cerebrospinal fluid leukocyte counts were 178 cells/mm³ in first episodes and 80.5 cells/mm³ in recurrent episodes. Conclusion: In this case series, clinical manifestations were similar between the first and recurrent episodes. No deaths or neurological sequelae were documented at discharge, and short-term outcomes were favorable. Recurrent enterovirus meningitis did not appear to be associated with a more severe clinical course. Keywords: enterovirus, meningitis, recurrence, children, Real-time PCR, cerebrospinal fluid. 09:36:52 query returned open=false 09:52:07 query returned open=false