title: Plasma cell cerebrospinal fluid pleocytosis does not predict West Nile virus infection.
abstract: OBJECTIVE
  Diagnosis of WNV (WNV) relies upon serologic testing which may take several days after the onset of clinical symptoms to turn positive. Anecdotal reports suggest the presence of plasma cells or plasmacytoid lymphocytes in the cerebrospinal fluid (CSF) may be an early indicator of WNV infection.
  
  
  METHODS
  The CSFs of 89 patients (12 with WNV, 12 with other viral illness {OVI}, and 65 with nonviral illness{NVI}) were compared for the presence of either plasma cells or plasmacytoid lymphocytes.
  
  
  RESULTS
  Plasma cells were rarely seen in any of the patients. Plasmacytoid lymphocytes were more commonly seen in WNV (58%) and OVI (50%) than NVI (11%). The differences were significant for WNV versus NVI, but not WNV versus OVI (P < 0.001 and P = 0.58, resp.).
  
  
  CONCLUSIONS
  A CSF pleocytosis with plasma cells or plasmacytoid lymphocytes was neither sensitive nor specific for the diagnosis of WNV infection.
authors: Department of Internal Medicine, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND 58202, USA.
authors: Michael
authors: M
authors: Jordan
authors: Avish
authors: A
authors: Nagpal
authors: William
authors: W
authors: Newman
authors: Paul A
authors: PA
authors: Thompson
authors: Paul J
authors: PJ
authors: Carson
mesh_terms: D000328:Adult; D000368:Aged; D002555:Cerebrospinal Fluid / Q000166:cytology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D007964:Leukocytosis / Q000134:cerebrospinal fluid* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D010950:Plasma Cells / Q000473:pathology*; D011237:Predictive Value of Tests; D014901:West Nile Fever / Q000134:cerebrospinal fluid* / Q000473:pathology; D014902:West Nile virus / Q000302:isolation & purification