title: Application of polymerase chain reaction and subsequent phylogenetic analysis to the diagnosis of enteroviral infection in the central nervous system.
abstract: BACKGROUND
  Enteroviral infections of the central nervous system (CNS) are often difficult to diagnose, even if consistent conventional laboratory methodologies are used.
  
  
  OBJECTIVE
  To clarify the efficiency of two polymerase chain reaction (PCR) methods for the sensitive detection of enteroviruses and for the identification of enteroviral genotypes based on phylogenetic analysis of the amplified genome sequences, and to facilitate the diagnosis of enteroviral infection in CNS.
  
  
  METHODS
  Cerebrospinal fluid (CSF), throat swab, rectal swab, and/or serum samples were collected from 171 patients with aseptic meningitis and 67 patients with febrile seizures. The samples were tested for the presence of enteroviruses by cell culture and PCR methods for the detection and identification of enteroviruses.
  
  
  RESULTS
  In 111 (64.9%) of 171 patients with aseptic meningitis, enteroviruses were isolated by cell cultures from any site. In 143 (83.6%) patients, including 110 of 111 patients with aseptic meningitis, the enteroviral genome was detected in CSF by PCR. No enterovirus was isolated from any site for the 67 patients with febrile seizures. PCR detected the enteroviral genome in CSF samples from 13 (61.9%) of 21 patients who developed febrile seizures in the summer (June-August). Phylogenetic analysis of amplified genome sequences showed that the major pathogens of febrile seizures in summer were group A coxsackieviruses, which are usually difficult to isolate by cell culture.
  
  
  CONCLUSIONS
  PCR methods for the detection and identification of enteroviruses were useful for the diagnosis of enteroviral infection in CNS.
authors.affiliation: Department of Paediatrics, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukusima 960-1295, Japan. mhosoya@fmu.ac.jp
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Hosoya
authors.forename: Masatoki
authors.initials: M
authors.lastname: Sato
authors.forename: Ken
authors.initials: K
authors.lastname: Honzumi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Katayose
authors.forename: Hiroko
authors.initials: H
authors.lastname: Sakuma
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ishiko
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shimada
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kato
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Suzuki
mesh_terms: D020805:Central Nervous System Viral Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D002555:Cerebrospinal Fluid / Q000821:virology; D002675:Child, Preschool; D004770:Enterovirus / Q000235:genetics / Q000254:growth & development / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D015994:Incidence; D007223:Infant; D007413:Intestinal Mucosa / Q000821:virology; D008297:Male; D008582:Meningitis, Aseptic / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D010614:Pharynx / Q000821:virology; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D012007:Rectum / Q000821:virology
chemical_list: D012367:RNA, Viral