Laboratory Diagnosis of Common Viral Infections of the Central Nervous System by Using a Single

Several studies have shown that if quick turnaround times are available for EV-PCR hospital length-of-stay, and duration of antibiotics is minimized (Archimbauld, 2009; Tattevin, 2002). Primary prevention of meningitis is accomplished by the administration of H. Stains for spirochetes, fungi, and bacterial organisms were negative. The percentage of culture- and PCR-positive CSF specimens differed considerably between the centers. Hence, the extraction efficiency was equal at all dilutions and no evidence for PCR inhibition was observed. An alternative method to explore the heterogeneity, the I2 index, was also used.

Rituximab administration has been associated with profound and long-lasting, albeit transient, antibody deficiency of usually 6–12 months’ duration, in our experience [6]. Seventeen of these were in babies aged less than 6 months, in whom the CNS infection was detected as part of a general infection screen; of the 34 older children and adults who were affected, 33 presented with meningitis and 1 had an encephalitic illness. The diagnosis of bacterial meningitis rests on CSF examination performed after lumbar puncture [1, 7]. The symptom duration is represented as box plots and compared between age groups. Evaluation of Cerebrospinal fluid lactate levels as an aid in differential diagnosis of bacterial and viral meningitis. All personal data was concealed.


A person may become infected by close contact with an infected person. These patients accounted for 30% of the 83 patients in this age group who were EV RT-PCR positive. The results for the last two samples which repeatedly tested negative by the Argene assay but which repeatedly tested positive by GXEA and the in-house reverse transcription-PCR were finally considered to be false negative by the Argene assay. Two hundred microliters of each CSF specimen were inoculated to monolayers of Vero or HeLa cell lines in 24-well plates. Despite the problems of under notification, possible under reporting of laboratory results, positive specimens other than those from cerebrospinal fluid, and the lack of laboratory confirmation in children with aseptic meningitis, this similarity suggests the cerebrospinal fluid data are representative of viral meningitis in England and Wales. One limitation of our study is that the samples were studied retrospectively and that the samples were enriched for ABM (mainly meningococcal ABM) as there were sent to the NRCM for suspicion of meningococcal meningitis.

Putative novel therapeutic targets are proposed. EV RNA was detected by the Penter RT-PCR assay in all CSF samples from which an EV strain was recovered by cell culture (Table ). The GeneXpert Dx system performs hands-off sample processing and real-time, multiplex PCR for detection of DNA or RNA. Food and Drug Administration (FDA)-approved test for enterovirus RNA detection. IL-1 type 1 receptor (IL-1R1) binds IL-1α and IL-1β, whereas IL-1 type 2 receptor (IL-1R2) has much higher affinity for IL-1β than IL-1α [11-13]. The 61 genotypes within the EV-B species are the most common cause of acute meningitis, a self-limiting inflammation of the meninges characterized by favorable outcome and a major reason for admission to hospital of children and young adults [6–9].

Bacterial meningitis typically begins with headache, nausea and vomiting, stiff neck (nuchal rigidity), and chills and fever. 1.3.17 CSF examination should include white blood cell count and examination, total protein and glucose concentrations, Gram stain and microbiological culture. Selected References These references are in PubMed. Both herpes simplex and varicella-zoster may infect the meninges by means of spread from cervical and dorsal root ganglia in a retrograde fashion much the way they spread in an antegrade fashion to the skin. Although EVs are usually isolated from specimens obtained from cerebrospinal fluid (CSF), throat swab, or stool, the sensitivity of detection based on virus culture is lower than that of molecular diagnosis based on gene amplification due to several constraints using virus-replicable cell lines (1, 3, 13). During this period a total of 361 samples of CSF (of patients younger than 11 years) were processed for bacterial culture and EV RT-PCR assay was performed in 194 of them.

Enteroviruses (echovirus 6, 21 and 30) were isolated from cerebrospinal fluid (CSF) in 26/37 (70%) and from stool samples of 20/21 (95%) of patients with no other etiology. Enteroviruses (EVs) of the Picornaviridae family (64 distinct serotypes) are etiological causes of neurological syndromes in infants and adults (9, 14).