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"nBackground: M. pneumoniae infection in children is usual and diagnosis of its neurologic complications for rapid treatment is very important. To compare the CSF- M. pneumoniae antibody level between febrile children with acute neurologic signs (Menigoencephalitis, Guillan Barre Syndrome (GBS), Transverse myelitis, Ataxia and so on) with unaffected ones. "n"nMethods: A cross sectional/ case control study in pediatric wards of Rasoul-e-Akram & Mofid hospitals (2007-2009) was done. The amount of Specific M. pneumoniae IgG (ELISA) antibody level determined in CSF of 55 cases and in 10 controls. Chi square values (CI 95%, p< 0.05) calculated for all categorical variables. Sensitivity; specificity; Positive Predictive Value (PPV); Negative Predictive Value (NPV) of CSF antibody level determined by using the Area under the ROC Curve. "n"nResults: Cases (n= 55) aged between five month to 13 years with mean age of 3.84±3.43 years. Area Under Curve (AUC) in ROC was 0.876 (%95 CI, 0.78- 0.96; p< 0.0001). Cut off level for antibody was 0.0025 with 73% sensitivity; 90% specificity; 100% PPV; 28.8% NPV. CSF antibody level had significant difference between cases and controls [0.08± 0.26 Versus 0.001± 0.001; p: 0.02]; It had poor agreement between cases and controls (Kappa= 0.27). Lowest amount seen in cases with aseptic meningitis; highest amount observed in cases with GBS and cases with focal neurologic signs. "n"nConclusion: The presence of very low amount (0.0025) of M. pneumoniae antibody in CSF of febrile children with acute neurologic signs had 70% sensitivity and 90% specificity; 100% PPV; but had low (28.8%) NPV. M. pneumoniae would be a rare cause in cases with aseptic meningitis. Finding the M. pneumoniae-DNAs in CSF are not so frequent (2%) but in high suspicious cases adding this test to determining the CSF antibody level might be helpful.

Mumps infection is endemic in Iran. Our objective was to evaluate the presence of anti mumps antibodies ( IgM & IgG) in cerebrospinal fluid in mumps meningoencephalitic children. A prospective/cross-sectional study was performed in Tehran, Iran (2003 to 2004) and serum anti mumps antibodies (IgM) were detected (quantitive; ELISA) in meningoencephaltis patients. Specific anti mumps antibodies (IgM & IgG) were detected in cerebrospinal fluids of mumps meningoencephalitis cases. 43 meningoencephalitic patients were tested (59.2% male and 40.8% female). The age of patients was 79.96 ± 4.7 month. 23 (78.7%) cases had specific mumps IgM in serum. None of cases had IgM antibodies in CSF. Anti mumps IgG antibody was detected in CSF of 7.5% (2/23) cases. We detected lower than expected frequency of local immunity to mumps virus in CSF of our cases. For better serologic diagnosis we recommend more sensitive methods like virus detection (PCR) or short-term culture of lymphocytes from cerebrospinal fluid in future studies.

"nBackground: In recent years, many ill cases with cytomegalovirus reactivation in non-immuno compromised persons reported. Goal of study: to determine the CMV infection in cerebrospinal fluid of aseptic meningoencephalitis children hospitalized in Rasul & Mofid hospital (2005-2007). "nMethods: In a cross sectional study 132 cases selected with simple sampling. CMV-DNA in their Cerebro spinal fluids searched by qualitative PCR. "nResults: The age range of the study patients was 5 month- 13 years, median age= 2±3.7 years; 87(65.9%) male and 45(34.1%) was female. The presenting signs and symptoms were convulsion 77(69.4%); meningitis 25(18.8%), loss of consciousness 47(37%); neurologic defects 15.9%. DNA extrated in 11 cases. Mycoplasma- DNA in 2cases; DNA-CMV detected 2(1.5%). Positive DNA HSV found in 7(15.3%) of patients. DNA- HSV type- 15.3% (7/132) cases. An infant 5 month age with developmental delay, microcephaly and recurrent convulsions. A 1 year girl with brain atrophy and progressive hydrocephaly with intracranial shunt "nConclusions: Differentiation between herpes meningoencephalitis and other encephalopathy based on clinical signs in children is too difficult. CMV (1.5%) has lower rate than herpes simplex type-1 (5.7%). In addition to CMV and HSV1 all of herpes family viruses (varicella, herpes 6, 7, Epstein barr virus) could have role in children with meningoencephalitis. In recent years a sensitive, rapid, simple diagnostic test "Single tube Multiplex PCR" in cerebro spinal fluid recommend. Rapid diagnosis and faster treatment is necessary for decreasing mortality and morbidity in all of herpes meningoencephalitis cases