title: Challenges in laboratory diagnosis of acute viral central nervous system infections in the era of emerging infectious diseases: the syndromic approach.
abstract: Many acute viral infections of the central nervous system (CNS) remain without etiological diagnosis. Specific treatment is available for only few of them; however, accurate diagnosis is essential for patient's life and public health.
  
  
  
  In the current article, the main parameters playing a role for a successful etiological diagnosis of acute CNS infections are analysed and the syndromic approach based on clinical and demographic data combined with surrogated indicators is discussed. For the development of a relevant test panel, knowledge on the microbes causing CNS infections in a particular geographic region is essential. The modern screening strategies covering a large panel of potential causative agents are described. Examples of the successful application of next generation sequencing in the identification of etiological agents, including novel and emerging viruses, are given. Expert commentary: Knowledge on epidemiology of the viruses, expertise on syndromic grouping of the etiological agents and advances in technology enable the laboratory diagnosis of acute CNS infections, and the rapid identification, containment and mitigation of probable outbreaks.
authors.affiliation: a Department of Microbiology, Medical School , Aristotle University of Thessaloniki , Thessaloniki , Greece.
authors.forename: Anna
authors.initials: A
authors.lastname: Papa
authors.affiliation: a Department of Microbiology, Medical School , Aristotle University of Thessaloniki , Thessaloniki , Greece.
authors.forename: Tzimoula
authors.initials: T
authors.lastname: Kotrotsiou
authors.affiliation: a Department of Microbiology, Medical School , Aristotle University of Thessaloniki , Thessaloniki , Greece.
authors.forename: Elpida
authors.initials: E
authors.lastname: Papadopoulou
authors.affiliation: b Viroscience Department , Erasmus Medical Centre , Rotterdam , The Netherlands.
authors.forename: Chantal
authors.initials: C
authors.lastname: Reusken
authors.affiliation: b Viroscience Department , Erasmus Medical Centre , Rotterdam , The Netherlands.
authors.forename: Corine
authors.initials: C
authors.lastname: GeurtsvanKessel
authors.affiliation: b Viroscience Department , Erasmus Medical Centre , Rotterdam , The Netherlands.
authors.forename: Marion
authors.initials: M
authors.lastname: Koopmans
mesh_terms: D000208:Acute Disease; D020805:Central Nervous System Viral Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*; D019411:Clinical Laboratory Techniques / Q000379:methods*; D003937:Diagnosis, Differential; D006801:Humans; D025202:Molecular Diagnostic Techniques; D013048:Specimen Handling; D013577:Syndrome; D014773:Virology / Q000379:methods*
keywords: Central nervous system; laboratory diagnosis; next generation sequencing; syndrome; viral infection