Application of polymerase chain reaction and subsequent phylogenetic analysis to the diagnosis of enteroviral infection in the central nervous system.
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.
Hosoya
Mitsuaki
M
Department of Paediatrics, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukusima 960-1295, Japan. mhosoya@fmu.ac.jp
Sato
Masatoki
M
Honzumi
Ken
K
Katayose
Masahiko
M
Sakuma
Hiroko
H
Ishiko
Hiroaki
H
Shimada
Yasushi
Y
Kato
Kazuo
K
Suzuki
Hitoshi
H
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
D012367:RNA, Viral