title: Detection of herpes viruses in children with acute appendicitis.
abstract: OBJECTIVE
  This study aimed to investigate the incidence of herpes simplex virus (HSV) types-1 and -2, varicella-zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpes virus 6 (HHV-6) and human herpes virus 7 (HHV-7) in childhood acute appendicitis.
  
  
  METHODS
  Polymerase chain reaction (PCR) assays were applied to detect herpes virus DNA in 38 children [11 girls and 27 boys, mean age 9 years (STD+/-2.59), range 6-14 years], who underwent an appendectomy within a 2.5-year period. Appendix, omentum and peripheral blood mononuclear cells (PBMCs) were available from each case. Of the 38 children with acute appendicitis, 20 (52.6%) had advanced (phlegmonous) acute appendicitis and 18 (47.4%) had perforated appendicitis and local peritonitis. Forty-one blood specimens from age-matched healthy children (25 female and 16 male), with clinical manifestations unrelated to viral infections served as negative controls.
  
  
  RESULTS
  CMV was the most frequently detected virus (8/38, 21%), followed by HHV-6 (3/38, 7.9%). EBV and HSV-1 were detected, though not in all three different types of tissue specimens tested. None of the samples examined were HSV-2-, VZV- or HHV-7-positive. Of all the specimens, the omentum was the most commonly infected tissue (63.0%) while the appendix and peripheral blood specimens were found to be positive for viral infection in 60.5% and 50% of cases, respectively. The CMV IgG+ antibodies were positive in 54% of the control cases while 86% of the same group presented HHV-6 IgG+ antibodies.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first study documenting the presence of herpes virus DNA in children with acute appendicitis, suggesting that possible viral infection or reactivation is associated with childhood appendicitis.
authors.affiliation: Laboratory of Virology, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece.
authors.forename: Polixeni
authors.initials: P
authors.lastname: Katzoli
authors.forename: George
authors.initials: G
authors.lastname: Sakellaris
authors.forename: Maria
authors.initials: M
authors.lastname: Ergazaki
authors.forename: George
authors.initials: G
authors.lastname: Charissis
authors.forename: Demetrios A
authors.initials: DA
authors.lastname: Spandidos
authors.forename: George
authors.initials: G
authors.lastname: Sourvinos
mesh_terms: D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood; D001064:Appendicitis / Q000453:epidemiology / Q000821:virology*; D002648:Child; D003587:Cytomegalovirus / Q000302:isolation & purification; D005260:Female; D006566:Herpesviridae Infections / Q000453:epidemiology / Q000821:virology*; D018259:Herpesvirus 1, Human / Q000302:isolation & purification; D014645:Herpesvirus 3, Human / Q000302:isolation & purification; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D015654:Herpesvirus 6, Human / Q000302:isolation & purification; D016199:Herpesvirus 7, Human / Q000302:isolation & purification; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction / Q000379:methods; D015995:Prevalence; D014777:Virus Diseases / Q000453:epidemiology / Q000821:virology*
chemical_list: D000914:Antibodies, Viral