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.
Clinical Microbiology Department of Science and Public Health, Sapienza University of Rome, Italy. aurelia.gaeta@uniroma1.it
Aurelia
A
Gaeta
Simona
S
Verzaro
Latte Maria
LM
Cristina
Carlo
C
Mancini
Cristina
C
Nazzari
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