Biomedical subjects

R B Tang

Publications and source records attributed to R B Tang.

At least 19 recordsLinked to original sources

PubMed2005

Molecular cloning and characterization of full-length cDNAs encoding a novel high-molecular-weight Dermatophagoides pteronyssinus mite allergen, Der p 11.

BACKGROUND: Dermatophagoides pteronyssinus (Dp) and D. farinae (Df) mites are the most important source of indoor aeroallergens. Most Dp mite allergens identified to date have relatively low molecular weights (MWs). Identification of high-MW mite allergens is a crucial step in characterizing the complete spectrum of mite allergens and to provide appropriate tools for diagnostic and therapeutic application. METHODS: The full-length Der p 11 cDNA clone was isolated using cDNA library immunoscreening, the 5'-3' rapid amplification of cDNA ends (RACE) system and polymerase chain reactions (PCR). The whole cDNA insert and its PCR-derived DNA fragments (p1 to p4) were generated and expressed in the Escherichia coli expression system. The allergenicity of the recombinant protein and its peptide fragments was examined by IgE immunodot assays. The IgE-binding reactivity of rDer p 11 was analyzed in the serum of 50 asthmatic children with positive reactivity to Dp mite extract. Its recombinant peptide fragments were also examined by immunodot assays in 30 mite-allergic children. RESULTS: Der p 11 cDNA consists of a 2625-bp open reading frame encoding a 103-kDa protein with 875 amino acids. It exhibits significant homology with the paramyosin of other invertebrates. The protein sequence alignment of this newly identified Dp mite allergen (denominated as Der p 11) revealed over 89% identity with Der f 11 and Blo t 1. Among 50 Dp-sensitive asthmatic children, rDer p 11 showed positive IgE-binding reactivity to 39 patients (78%). Using immunodot assays, multiple human IgE-binding activities were demonstrated in all four fragments of Der p 11. Using immunoblot assays, the dominant IgG-binding epitope for monoclonal antibody (mAb642) was located in fragment p3 only. In immunoblot assays, cross-inhibition between rDer p 11 and rDer f 11 was up to 73-80% at concentrations of 100 microg/ml. CONCLUSIONS: This study confirms that the newly identified recombinant Der p 11 is a novel and important high-MW Dp mite allergen for asthmatic children. Our data also indicates that human IgE-binding major epitopes are scattered over the entire molecule of Der p 11.

Adolescent↗

PubMed2001

Serum levels of eosinophil cationic protein and eosinophils in asthmatic children during a course of prednisolone therapy.

Eosinophils play an important role in the inflammatory events of allergic asthma. Serum eosinophil cationic protein (ECP) is a marker of disease activity and of treatment efficacy in bronchial asthma. To understand the role of ECP concentrations in disease activity of acute asthma, we determined changes in serum concentrations of ECP elaborated by activated eosinophil before and after prednisolone therapy. Circulating levels of ECP in 15 normal control subjects, and in sera of 20 asthmatic children who were allergic to house dust mites, were measured during an acute exacerbation and when the children were in stable condition, using commercially available assay kits. The mean concentrations of serum ECP were significantly higher during an acute asthma exacerbation than when the children were stable (26.41 +/- 21.66 microg/L vs 15.74 +/- 11.36 microg/L P < 0.01) or when compared to control subjects (7.50 +/- 1.42 microg/L; P < 0.001). The mean eosinophil counts (EC) during acute asthma attacks (575 +/- 286/mm3) and when stable (467 +/- 204/mm3) were higher than in the control group (181 +/- 164/mm3). The differences were statistically significant among the three groups (P < 0.05). A significant correlation was found between serum levels of ECP and EC (r = 0.788, P = 0.001) in asthmatic children; there were also significant correlations between ECP and EC in nonallergic normal control subjects (r = 0.662; P = 0.007). In conclusion, this study provides further evidence that changes in serum ECP may serve as an objective indicator for clinical activity and results of treatment in allergic asthmatics.

Adolescent↗

PubMed2001

Interleukin-1beta and tumor necrosis factor-alpha in cerebrospinal fluid of children with bacterial meningitis.

Certain cytokines may contribute to the sequence of events that lead to meningeal inflammation in bacterial meningitis. The purpose of this study was to determine the levels of cytokines in the cerebrospinal fluid (CSF) of children with bacterial meningitis and aseptic meningitis of different etiologies. We determined the concentrations of interleukin-1beta (IL-1beta) and tumor necrosis factor (TNF-alpha) in the CSF of 171 specimens of 144 patients whose cases were classified as follow: bacterial meningitis (n=23), aseptic meningitis (n=26) and non-meningitis (n=95). The detectable IL-1beta concentration (> or =20 pg/ml) in the bacterial meningitis, aseptic meningitis and non-meningitis groups were observed with 78.3%, 3.8%, and 8.4%, respectively. Significantly higher serum IL-1beta concentrations were detected in those with bacterial meningitis than those with aseptic meningitis (538.93+/-605.32 pg/ml vs 2.52+/-11.57 pg/ml; P<0.001) or among non-meningitis subjects (2.90+/-11.91 pg/ml; P<0.001). The mean TNF-alpha concentration was 148.74+/-338.77 pg/ml. There was significantly more TNF-alpha than aseptic meningitis (6.85+/-17.93 pg/ml; P<0.001) or non-meningitis (7.67+/-16.07 pg/ml; P<0.001). With regard to diagnosis, measurement of IL-1beta and TNF-alpha levels showed sensitivities of 78% and 74%, respectively; specificities of 96% and 81%, respectively. It is suggested that the levels of these cytokines, especially IL-1beta and TNF-alpha, are useful markers for distinguishing bacterial meningitis from aseptic meningitis.

Adolescent↗

PubMed2001

Soluble interleukin-2 receptor and interleukin-4 in sera of asthmatic children before and after a prednisolone course.

BACKGROUND: Cytokine-mediated interactions among inflammatory cells may play a role in the pathogenesis of bronchial asthma. OBJECTIVE: To understand the role of soluble interleukin-2 receptor (sIL-2R) and interleukin-4 (IL-4) in the disease activity of acute asthma, changes in serum concentrations of sIL-2R and IL-4 elaborated by activated T-lymphocyte before and after prednisolone therapy with clinical improvement were determined in the present study. METHODS: Circulating levels of sIL-2R and IL-4 in sera from 15 normal control subjects and in sera from 20 allergic asthmatic children with acute exacerbation and in a stable condition were determined by using commercially available ELISA kits. RESULTS: The mean concentration of serum sIL-2R was significantly higher in acute exacerbation than in children with stable asthma (368.9 +/- 395.4 pg/mL vs 291.2 +/- 361.0 pg/mL; P < .01) or in control subjects (124.6 +/- 17.8 pg/mL; P < .001). The mean concentration of serum IL-4 was higher in acute exacerbation (5.82 +/- 1.10 pg/mL) and in stable asthmatic patients (6.73 +/- 2.83 pg/mL) versus control group subjects (5.54 +/- 1.20 pg/mL). However, the difference was not statistically significant among the three study groups. CONCLUSIONS: This study provides further evidence that changes in serum IL-2R may serve as an objective indicator for clinical outcome of allergic asthmatic patients.

Adolescent↗

PubMed2001

Serum specific IgE reactivity to recombinant Der f 11 in asthmatic children.

This study was designed to examine the prevalence of positive serum IgE reactivity to the recombinant group 11 Dermatophagoides farinae allergen (rDer f 11) in asthmatic children in Taiwan. Using immunoblot analysis in a preliminary study of 18 asthmatic children, 13 (72.2%) reacted positively to rDer f 11 and 16 (88.9%) showed positive reactivity to D. farinae extracts. The allergenicity of rDer f 11 was further evaluated with in vivo skin tests and in vitro IgE immunodot assays in 24 mite skin-test-positive asthmatic children. Whereas 17 (70.8%) had positive skin tests to rDer f 11, 18 (75.0%) had positive serum IgE reactivity to rDer f 11. A good coincidence (87.5%) between the immunodot assay and the skin test was confirmed in these asthmatic children. Moreover, the prevalence of serum IgE reactivity to rDer f 11 was further investigated in a large panel of 49 mite skin-test-positive asthmatic children. Again, 38 (77.6%) had positive serum IgE reactivity to rDer f 11 in immunodot assays. Taken together the positive IgE reactivity to rDer f 11 in immunodot analysis ranged from 75 to 77.6% in two groups of 73 mite skin-test-positive asthmatic children. High incidence of serum IgE antibodies specific for rDer f 11 in the present study suggests that Der f 11 is a novel major allergen of house dust mites.

Adolescent↗

PubMed2001

Prevalence and relationship between allergic diseases and infectious diseases.

In order to determine the prevalence of childhood allergic diseases, infectious diseases, and the relationship between them, 8723 children from three junior high schools in Tou-Cheng City, Taipei County, were studied using questionnaires developed according to the International Study of Asthma and Allergies in Childhood (ISAAC) criteria combined with supplementary questions about infectious diseases. Students and their parents completed the questionnaires at home. The age of the children ranged from 10 to 18 years old (14.12 +/- 0.89 years), the majority (96.03%) was aged from 13 to 15 years old. The 12-month prevalences of self-reported allergic disease symptoms were: asthma symptom 8.2%, allergic rhinitis symptom 39.6%, and atopic dermatitis symptom 5.9%. The prevalences of diagnosis of the allergic diseases were: asthma 8.7%, allergic rhinitis 24.1%, and atopic dermatitis 3.9%. The 12-month prevalences of diagnosis of infectious diseases were: pneumonia 0.6%, bronchitis 7.2%, sinusitis 7.2%, purulent conjunctivitis 2.5%, otitis media 4.3%, encephalitis or meningitis 0.4%, gastroenteritis 14.5%, acne 23.9%, purulent dermatitis 1.3%, and other infectious diseases 1.2%. Lifetime admission rates of children due to infectious diseases were: pneumonia 1%, bronchitis 1.8%, sinusitis 0.3%, purulent conjunctivitis 0.2%, otitis media 0.3%, encephalitis or meningitis 0.3%, gastroenteritis 2.1%, and other infectious diseases 0.6%. The prevalence of infectious diseases was significantly higher in children with allergic disease symptoms (defined as asthma, allergic rhinitis, or atopic dermatitis). These results demonstrated the presence of a link between allergic diseases and infectious diseases, which may have some important clinical implications.

Adolescent↗

PubMed2001

Serum interleukin-6 and tumor necrosis factor-alpha concentrations in children with mycoplasma pneumonia.

A prospective study was performed to assess the relationship among interleukin-6, tumor necrosis factor-alpha, C-reactive protein serum concentrations, and the severity of mycoplasma pneumonia in 49 children. Mycoplasma pneumonia was diagnosed by chest film and anti-Mycoplasma pneumoniae IgM antibody test. Serum concentrations of interleukin-6 and tumor necrosis factor-alpha were measured by using enzyme-linked immunosorbent assays. Interleukin-6 serum levels in mycoplasma pneumonia patients with fever for more than 3 days (41.98 +/- 67.46 [SD] pg/mL) were significantly higher than those in patients with fever < or = 3 days (10.01 +/- 11.74 pg/mL, p < 0.05). Interleukin-6 serum levels in those patients whose chest films revealed patchy consolidations or pleural effusion (58.11 +/- 92.19 pg/mL) were significantly higher than those in patients whose chest films revealed peribronchial interstitial infiltration (15.94 +/- 20.81 pg/mL, p < 0.05). The mean levels of serum tumor necrosis factor-alpha were not statistically significant in the different duration of fever and chest film findings. These results suggest that interleukin-6 serum concentration, rather than tumor necrosis factor-alpha, may be a potential indicator of the severity and outcome of mycoplasma pneumonia.

C-Reactive Protein↗

PubMed2001

Pulmonary function during exercise in obese children.

BACKGROUND: Obesity imposes additional stress to ventilation during exercise. The purpose of this study is to evaluate the pulmonary function changes with graded exercise and the habitual level of physical activity in obese children. METHODS: This study recruited 42 obese and 10 normal students, aged 11, from Tamsui Elementary School. Measurements of cardiopulmonary fitness were recorded after a jump rope test. Height, weight and body mass indices were determined before testing. RESULTS: A significant correlation was found between triceps skin-fold thickness and the body mass index (BMI; r = 0.65, p < 0.05). Blood systolic pressure significantly increased in the obese subjects in their post-exercise test. There was no significant difference between the obese and the non-obese groups in any of the lung function test measurements. Forced expiratory volume in the first second (FEV1), peak expiratory flow rate (PEFR) and forced vital capacity (FVC) were similar in both groups. CONCLUSIONS: Physiologic responses are not sufficiently different from between the obese subjects and the non-obese children. We should pay more attention to fostering confidence in the obese child exercise.

Child, Preschool↗

PubMed2000

Evaluation of serum interleukin-8 as a marker of disease activity in acute asthma in children.

Cytokine-mediated interactions among the inflammatory cells may play a role in the pathogenesis of bronchial asthma. Interleukin-8 (IL-8) is a major cytokine in the recruitment of neutrophils to the area of inflammation. Serum IL-8 is a marker of disease activity and treatment efficacy in bronchial asthma. To understand the role of IL-8 in disease activity in acute asthma, changes in serum concentrations of IL-8 elaborated by activated eosinophil before and after prednisolone therapy with clinical improvement were determined in the present study. Circulating levels of IL-8 in 15 normal control subjects and in sera from 20 allergic asthmatic children with acute exacerbation and in stable condition were determined by using commercially available assay kits. The mean concentration of serum IL-8 was statistically significantly higher in asthmatic children with acute exacerbation (63.62 +/- 11.41 pg/mL) and in stable asthmatics (64.22 +/- 10.31 pg/mL) compared to the control group subjects (50.40 +/- 30.70 pg/mL; p < 0.01). However, the difference was not statistically significant between the acute exacerbation and stable asthmatics groups (p > 0.05). Serum IL-8 is a poor indicator of disease activity in acute asthma; therefore, monitoring by serum IL-8 concentration is of limited value. The clinical value of serum IL-8 as a marker of disease activity remains to be established.

Acute Disease↗

PubMed2000

The assessment of anaerobic blood culture in children.

Over the past 20 years, there has been a decline in the percentage of positive blood cultures yielding anaerobic organisms. Due to the limited blood volume drawn from pediatric patients, we have assessed the value of routine anaerobic blood cultures in children. From January 1994 to December 1998, 9886 paired aerobic and anaerobic blood cultures were analyzed in the pediatric microbiology laboratory at the Taipei Veterans General Hospital. Six hundred and eighteen (6.25%) isolates were considered to be clinically important microorganisms. Staphylococci, streptococci, aerobic gram-negative bacilli, and yeasts showed more significant growth within the aerobic culture than that within the anaerobic culture. Significantly more aerobic gram-positive cocci, aerobic gram-negative bacilli, and yeasts were detected at least 1 day earlier by using the aerobic culture. Three patients with documented anaerobic bacteremia had obvious symptoms related to anaerobic infections. Our study concludes that routine use of anaerobic blood culture in pediatric patients is not necessary. Anaerobic blood cultures should be reserved for patients with diseases like intra-abdominal or oral infections, neutropenic patients on steroid therapy, pressure sores, cellulitis, and human bite wounds.

Bacteremia↗

PubMed2000

Cytomegalovirus pericarditis with cardiac tamponade in a young infant.

The principal viruses implicated in pericarditis are enteroviruses. Cytomegalovirus pericarditis is quite rare and has been reported in immunocompromised patients with acquired immunodeficiency syndrome, malignant neoplasm or organ transplantation. We report a three-month-old male infant who suffered from cough and rhinorrhea for two weeks. He developed shortness of breath for three days, and fever for one day, prior to admission. Physical examination revealed tachycardia, tachypnea, pale conjunctiva, hepatomegaly, and a muffled heart sound without significant murmur. Chest radiography showed marked enlargement of the cardiac silhouette. Echocardiography demonstrated a large amount of pericardial effusion with impaired diastolic ventricular function. After pericardial drainage and supportive treatment, the fluid gradually disappeared. Viral culture of the pericardial fluid and serologic data confirmed a cytomegalovirus infection. Cytomegalovirus pericarditis should be included in the differential diagnosis of pericardial effusion in a young infant.

Cardiac Tamponade↗

PubMed2000

Isolation of Aeromonas hydrophila in children with diarrhea.

Aeromonas species are gram-negative bacilli that lead to a wide spectrum of infectious diseases in human. In the present study, these bacilli were reviewed to assess their significance as enteric pathogens in this area. During the years of 1994 to 1998, the clinical microbiology laboratory received 2150 stool specimens of children with diarrhea. Medical charts of patients who had positive culture for Aeromonas hydrophila were reviewed. A. hydrophila were isolated from 50 (2.3%) of 2150 children with diarrhea. Most patients were outpatients with ages ranging from 5 months to 16 years old (mean age 3.5 years). The male to female ratio was 0.85:1. All patients suffered from watery or loose diarrhea, some with blood-tinged stool. Whether or not they received medication, all patients had uneventful recoveries. The results of antibiotic susceptibility testing revealed that all strains were not susceptible to ampicillin. In summary, A. hydrophila may be considered as a causative agent of gastrointestinal illness in children.

Adolescent↗

PubMed2000

Significance of specific IgG subclass antibodies to house dust mites in asthmatic children.

BACKGROUND: Dermatophagoides pteronyssinus (Dp) and Dermatophagoides farinae (Df), the major components of house dust, are considered to be etiologic factors of extrinsic asthma. The relationships between immunoglobulin (Ig) G subclass antibodies specific for Dp (or Df) were compared in specific IgE-positive and -negative asthmatic children. METHODS: Serum levels of IgG and IgE subclass antibodies specific for Dp and Df were studied in 52 children (age, 3-13 years; mean age, 8.4 years) with asthma using enzyme-linked immunosorbent assays. The skin prick test was also used in diagnosis of the reactivity of allergic disease. RESULTS: The levels of serum-specific IgG1 and IgG2 to Dp and Df in mite-specific IgE-(or skin-test) positive asthmatic children were significantly higher than those in mite-specific IgE- (or skin test) negative children (p < 0.01). Significant correlations between the level of the specific IgE and IgG1 (r = 0.6067; p = 0.0001) or IgG2 (r = 0.5851; p = 0.0002) to Dp, and IgG1 (r = 0.3823; p = 0.0214) or IgG2 (r = 0.5057; p = 0.0017) to Df were found. The specific IgE level and skin test reactivity showed a high correlation of greater than 96% (50/52). CONCLUSIONS: The levels of mite-specific IgG subclasses were partially compatible to specific IgE levels and skin test reactivity. We conclude that house dust mite allergy is significantly associated with specific IgG1, IgG2 and IgE responses.

Adolescent↗

PubMed2000

Evaluation of different blood culture media in neonatal sepsis.

Blood drawn from neonatal patients is available in only limited amounts for blood cultures. The BACTEC Pediatrics (PEDS) Plus aerobic nonradiometric blood culture bottle was designed to aid the diagnosis of pediatric bacteremia. To assess the value of PEDS Plus blood culture medium for neonatal patients, we prospectively compared the PEDS Plus blood culture medium with the standard BACTEC aerobic medium (NR6A). From January to December 1999, 192 pairs of PEDS Plus and NR6A blood culture bottles were collected by the pediatric microbiology laboratory of Taipei Veterans General Hospital. Seventeen (8.85%) isolates were considered to be clinically significant microorganisms. Isolation rate of the PEDS Plus culture bottles was significantly higher than that of the NR6A culture bottles (p < 0.001). Six isolates were detected at least 1 day earlier by using the PEDS Plus culture bottles (p < 0.001). Among those patients who were under antibiotic therapy, the PEDS Plus culture bottle showed more significant growth than the NR6A culture bottle (p < 0.001). After weighing their benefits, we suggest substituting PEDS Plus bottles for NR6A bottles when culturing blood from neonatal patients or from those who are receiving antibiotic therapy.

Bacteremia↗

PubMed2000

The evaluation of allergens and allergic diseases in children.

Knowing the incidence of allergic diseases and their relationship with allergens is a crucial requirement for therapeutic judgment. We present our experience on the incidence, clinical features and allergens of the allergic diseases detected by multiple allergosorbent chemiluminescent assay (MAST-CLA) in children from 1997 to 1999 at the Taipei Veterans General Hospital. The incidence of bronchial asthma, allergic rhinitis and atopic dermatitis are significantly different when stratified by age groups. Among the enrolled 2008 patients, 980 (48.8%) patients have positive MAST-CLA results. Of these, 562 (57.3%) are male and 418 (42.7%) are female. A significant increase among patients with positive allergens is also found when stratified by age group. Inhalant allergen is the major allergen detected in our patients. House dust mites Dermatophagoides pteronyssinus (Dp) and Dermatophagoides farinae (Df), cockroaches, feathers, and dog dander show the highest incidence in the 7- to 12-year-old group. In the fungal group, Aspergillus and Penicillium also show a significant difference in the incidence among different age groups. Pollen allergens, on a whole, show significant difference in incidence among different age groups. The food allergen group shows variable significant difference in incidence. Crab, milk, and egg white show the highest significant incidence in the 2- to 6-year-old group. These results suggest that the incidence of allergens detected in allergic diseases varies among different age groups.

Adolescent↗

PubMed1999

Tumor necrosis factor-alpha and interleukin-6 profiles in children with pneumonia.

Pneumonia is a common cause of hospitalization and is associated with high morbidity in children. Tumor necrosis factor-alpha (TNF-alpha) and Interleukin-6 (IL-6) are primary mediators of inflammation, and have been implicated in a large number of infectious and non-infectious inflammatory diseases. The serum concentrations of TNF-alpha and IL-6 were measured by enzyme-linked immunosorbent assay (ELISA) in 27 patients with bacterial pneumonia (n = 12) or respiratory syncytial virus (RSV) pneumonia (n = 15) and in 15 healthy control subjects. TNF-alpha concentrations of patients with bacterial pneumonia in acute stage (16.94 +/- 5.70 ng/L) were significantly higher than those in convalescent stage (5.80 +/- 0.75 ng/L), in patients with RSV pneumonia (5.06 +/- 0.44 ng/L) and in healthy control subjects (5.39 +/- 0.68 ng/L) (p < 0.005). TNF-alpha concentrations of patients with RSV pneumonia were not significantly different from those of the control group. IL-6 concentrations of patients with bacterial pneumonia in acute stage (465.94 +/- 290.30 ng/L) were significantly higher than those in convalescent stage (22.04 +/- 15.08 ng/L), in patients with RSV pneumonia (7.65 +/- 2.58 ng/L), and in healthy control subjects (0.84 +/- 0.08 ng/L) (p < 0.0005). There was significant difference between patients with RSV pneumonia and the healthy control group (p < 0.005). In summary, there were significant differences in TNF-alpha and IL-6 concentrations between acute stage and convalescent stage in patients with bacterial pneumonia, making them useful as markers for bacterial pneumonia. Further studies are needed to establish the potential diagnostic and prognostic value of TNF-alpha and IL-6.

C-Reactive Protein↗

PubMed1998

Isolation and characterization of a novel 98-kd Dermatophagoides farinae mite allergen.

BACKGROUND: Exposure to allergens from house dust mites is a significant cause of immediate hypersensitivity. Thus far, the active mite allergens defined are low molecular weight (MW) proteins or glycoproteins. However, other important mite allergens remain to be investigated. In this study a high MW mite antigen with a high IgE-binding activity was characterized. METHODS: An anti-Dermatophagoides farinae (Df) monoclonal antibody, mAb642, which recognized a 98-kd allergenic mite protein, was used for affinity chromatography. The purified Df642 was characterized biochemically and immunologically. RESULTS: Competitive ELISA demonstrated that mAb642 was inhibited by the interaction between serum IgE from allergic patients and Df642 antigen in a dose-dependent fashion. The IgE reactivity to both 98-kd and 92-kd components was removed or diminished by preincubation of asthmatic sera with Df642-coated CNBr-activated cellulose-4B gel. Two-dimensional immunoblot analysis revealed that there are at least 4 isoforms of Df642 that represent a minor component in the crude mite extract. The allergenicity of Df642 was assayed by IgE immunoassay with a large panel of 67 sera from asthmatic patients with positive skin reactions, and Df 642 showed positive IgE reactivity with more than 80% of the sera tested. Thus it should be classified as an important allergen. In addition, amino acid sequence analysis revealed that Df642 shares more than 50% homology with paramyosin from invertebrates. CONCLUSION: We have identified and characterized a 98-kd house dust mite allergen that showed greater than 80% IgE reactivity with sera from patients allergic to mites. This is the first high MW allergen characterized to date, and it shares high sequence homology with paramyosins in invertebrates.

Adolescent↗

PubMed1998

Coxsackievirus B1 infection in infants less than 2 months of age.

Most of the neonatal enteroviral infections reported in the literature are associated with Coxsackievirus B2-B5 and echovirus 9 and 11. We report a retrospective Coxsackievirus B1 (CB1) infection in infants less than 2 months of age. Seventeen patients had aseptic meningitis and 8 had systemic sepsis (multi-organ involvement including meningitis, impaired liver function, and abnormality in coagulation). The symptoms and signs were nonspecific and could not be distinguished with bacterial infection on clinical grounds. Virus isolation was mandatory for diagnosis. Impaired liver function and coagulation profiles were noted in patients with systemic sepsis, but not in patients with meningitis only. CSF examination showed some uncommon features of viral meningitis: predominance of polymorphonuclear cells (PMN) was noted in 62.5% of patients and hypoglycorrhachia in 64% of patients. The patients with only meningitis recovered completely without any sequela. One of the eight patients with systemic sepsis died with case fatality rate 12.5%. Physicians should be aware of the possibility of CB1 virus infection in young infants during prevalent seasons. Specimens should be sent for viral culture in patients with meningitis and sepsis to make a definite diagnosis.

Age of Onset↗