Volume 92 Number 2

B r i e f cfinical and laboratory observations

Fernandez PC, and Kovnat PJ: Metabolic acidosis reversed by the combination of magnesium hydroxide and a cationexchange resin, N Engl J Med 268:23, 1972.

Aseptic meningitis and orchitis associated with echovirus 6 infection Robert C. Welliver, M.D., and James D. Cherry, M.D.,* Los Angeles, C a l i f

THE CLINICAL SYNDROME o f aseptic meningitis a n d orchitis with or without parotitis is usually attributed t o m u m p s virus infection. 1 D o u b t regarding the correct diagnosis m a y arise if a patient has a history of previous m u m p s infection or vaccination. Except for one r e p o r t e d case o f aseptic meningitis, orchitis, a n d p a r o t i t i s associated with lymphocytic choriomeningitis virus infection, this s y n d r o m e has not b e e n n o t e d in association with other viruses.'-' W e report a case o f viral meningitis a n d orchitis occurring in a p a t i e n t in w h o m echovirus 6 infection was confirmed. This is also the first occurrence of orchitis associated with a n enterovirus o t h e r t h a n one of the Coxsackie B group.

CASE REPORT On December 3, 1976, a 17-year-old white boy developed swelling and tenderness in the right testicle. On the next day he developed fever to 38.3C and headache; on the following day he was admitted to the hospital because of nuchal rigidity and vomiting. At age one year he had been treated with radiation and left orchiectomy for carcinoma (type unknown) of the left testicle. His parents stated he had had mumps in early childhood. Neither the patient nor his family had any illness in the month prior to the onset of his orchitis, and he denied exposure to mumps. He had a pet rabbit, which was well, and denied exposure to rats, hamsters, and mice. He had been receiving prednisone continuously for chronic asthma until four months prior to admission. His only

From the Department of Pediatrics, Division of Infectious Diseases, UCLA Center for the Health Sciences.

Supported in part by the Allergy Research Foundation, Los Angeles. *Reprint address: Department of Pediatrics, UCLA Center ,for the Health Sciences, Los Angeles, CA 90024.

0022-3476/78/0292-0239500.20/0 9 1978 T h e C. V. M o s b y C o .

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Seldin DW, and Rector FC: The generation and maintenance of metabolic alkalosis, Kidney Int 1:306, 1972.

current medication was beclomethasone, taken in two breaths four times a day. Physical examination revealed a thin, acutely ill adolescent with a temperature of 38.4 C. He was irritable and resisted neck flexion because of pain. He had no parotid swelling and the orifices of the Stensen ducts were not inflamed. The right testicle was swollen, with warmth and erythema of the overlying skin. Laboratory data revealed a hemoglobin concentration of 13.9 gm/dk The white blood cell count was 20,200/ram ~ with a differential of 63% segmented neutrophils, 2% band forms, 4% eosinophils, and 31% lymphocytes. The serum amylase value was 71 mg/dl (normal

Aseptic meningitis and orchitis associated with echovirus 6 infection.

Volume 92 Number 2 B r i e f cfinical and laboratory observations Fernandez PC, and Kovnat PJ: Metabolic acidosis reversed by the combination of mag...
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