Diagnosis of neurological herpesvirus infections: real time PCR in cerebral spinal fluid analysis.
Human herpesviruses (HHVs) cause many serious acute and persistent central nervous system (CNS) disorders. Because these infections manifest with various, often non-specific, symptoms and signs, and because specific therapy is often available, accurate diagnosis is essential. Cerebrospinal fluid (CSF) from 146 patients with acute meningitis or meningoencephalitis and 9 with "other neurological disorders" were analyzed by using an automatic system for nucleic acid extraction and quantitative real-time polymerase chain reaction (PCR) for herpes simplex 1 and 2 (HSV-1, HSV-2), Epstein-Barr virus (EBV), human cytomegalovirus (HCMV), herpesvirus-6 (HHV-6), and varicella-zoster virus (VZV). HHVs DNA was detected in 52 of 155 (33.5%) analyzed samples. In 39 CSF samples from patients with meningoencephalitis we found: VZV in 13, HSV-1 in 12, EBV in 6, HHV-6 in 4, and HSV-2 in 4. Co-infections of EBV and HSV-2, HSV-1 and HSV-2, HSV-1 and VZV were also disclosed in four cases. In addition, two patients with Guillain-Barré syndrome had HCMV and one showed HHV6 positivity, two patients with myelitis / polymyeloradiculitis had VZV and HCMV respectively, HHV-6 DNA was found in one patient with lateral amyotrophic sclerosis. Three CSF specimens from HIV-infected patients with CNS complications had HHV-6 or EBV DNA. Moreover quantitative data were also correlated to clinical conditions to obtain more information on the virus aetiopathogenic role.
Gaeta
Aurelia
A
Clinical Microbiology Department of Science and Public Health, Sapienza University of Rome, Italy. aurelia.gaeta@uniroma1.it
Verzaro
Simona
S
Cristina
Latte Maria
LM
Mancini
Carlo
C
Nazzari
Cristina
C
D000328:Adult; D020805:Central Nervous System Viral Diseases / Q000175:diagnosis* / Q000821:virology; D002555:Cerebrospinal Fluid / Q000821:virology; D004279:DNA, Viral / Q000032:analysis / Q000302:isolation & purification; D005260:Female; D006564:Herpesviridae / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D006566:Herpesviridae Infections / Q000175:diagnosis* / Q000821:virology; D006801:Humans; D008297:Male; D008587:Meningitis, Viral / Q000175:diagnosis / Q000821:virology; D008590:Meningoencephalitis / Q000175:diagnosis / Q000821:virology; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D012680:Sensitivity and Specificity
D004279:DNA, Viral