Nested polymerase chain reaction in cerebrospinal fluid for diagnosing spinal cord schistosomiasis: A promising method.
BACKGROUND
Spinal cord schistosomiasis is a neglected, disabling neurological disease commonly identified in patients from northeast Brazil. The methods currently available for its diagnosis need improvement. PCR in feces and urine is a sensitive diagnostic tool for diagnosis of schistosomiasis, but its value in the cerebrospinal fluid (CSF) is still unknown.


OBJECTIVE
The objective of this study was to detect Schistosoma mansoni DNA in CSF from patients with spinal cord schistosomiasis, using the nested PCR (NPCR) assay.


METHODS
This was a cross-sectional study carried out from March 2013 to January 2014 at the Aggeu Magalhães Research Center/FIOCRUZ (Pernambuco state, Brazil). NPCR was used to detect Schistosoma mansoni DNA in CSF samples from 20 patients with spinal cord schistosomiasis and 30 controls.


RESULTS
NPCR was positive in 16 patients with spinal cord schistosomiasis and none from the control group (sensitivity 80%; specificity 100%, positive predictive value 100%; negative predictive value 88.2%).


CONCLUSIONS
The NPCR technique is highly sensitive and specific for diagnosis of spinal cord schistosomiasis and can be an important diagnostic tool, particularly in cases with negative CSF serology.
School of Medicine, University of Pernambuco, Recife, Pernambuco state, Brazil.
Igor Silvestre
IS
Bruscky
Aggeu Magalhaes Research Center/FIOCRUZ, Recife, Pernambuco state, Brazil.
Fábio Lopes
FL
de Melo
University of Pernambuco, Aggeu Magalhaes Research Center/FIOCRUZ, Recife, Pernambuco state, Brazil.
Zulma Maria
ZM
de Medeiros
Pernambuco Center for Neurological Diagnosis, Recife, Pernambuco state, Brazil.
Flávia Falcão
FF
Albuquerque
Aggeu Magalhaes Research Center/FIOCRUZ, Recife, Pernambuco state, Brazil.
Leandro Batista
LB
Wanderley
Oswaldo Cruz University Hospital, University of Pernambuco, Recife, Pernambuco state, Brazil. Electronic address: carolina.dra@gmail.com.
Carolina
C
da Cunha-Correia
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001938:Brazil; D003430:Cross-Sectional Studies; D018509:DNA, Helminth / Q000032:analysis*; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*; D012550:Schistosoma mansoni / Q000235:genetics*; D012555:Schistosomiasis mansoni / Q000134:cerebrospinal fluid* / Q000188:drug therapy; D012680:Sensitivity and Specificity; D013118:Spinal Cord Diseases / Q000134:cerebrospinal fluid* / Q000188:drug therapy; D055815:Young Adult
D018509:DNA, Helminth
Myelitis; Neuroschistosomiasis; Polymerase chain reaction; Schistosomiasis; Schistosomiasis mansoni