PMID- 25178670
OWN - NLM
STAT- MEDLINE
DCOM- 20150708
LR  - 20141202
IS  - 1879-0070 (Electronic)
IS  - 0732-8893 (Linking)
VI  - 80
IP  - 3
DP  - 2014 Nov
TI  - Clinical application of viral cerebrospinal fluid PCR testing for diagnosis of 
      central nervous system disorders: a retrospective 11-year experience.
PG  - 207-15
LID - S0732-8893(14)00316-2 [pii]
LID - 10.1016/j.diagmicrobio.2014.07.010 [doi]
AB  - The cerebrospinal fluid (CSF) polymerase chain reaction (PCR) is the gold 
      standard to detect cerebral viral activity. As positive findings do not prove an 
      impact on the neurological disorder, data interpretation is difficult. To better 
      assess the impact of positive CSF PCR findings in different neurological diseases 
      and to identify coherences facilitating CSF PCR data interpretation, we performed 
      this retrospective analysis of CSF PCR data of 481 pediatric and 2604 adult 
      patients, including herpes simplex virus (HSV), varicella zoster virus (VZV), 
      Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), and 
      enteroviruses (EV). Nucleic acid of EBV was detected in 1.6% (39/2449), of VZV in 
      1.3% (34/2624), of HSV in 1.24% (37/2994), of EV in 0.4% (10/2364), of HHV-6 in 
      0.17% (4/2417), and of CMV in 0.2% (5/2514) of the patients. Newborns and elderly 
      people showed highest infection rates. HSV, VZV, and EV prevailed in typical 
      infectious central nervous system (CNS) diseases; EBV, in further inflammatory 
      neurological diseases; HSV and EBV, in immunocompromised patients; and EBV, HSV, 
      and HHV-6, in further non-inflammatory neurological diseases. Analysis of 
      successive PCR studies revealed delayed viral detection for EBV (6/147) and HSV 
      (1/217), respectively. Rapid viral clearance was typical for HSV, VZV, CMV, and 
      EV infections, although the maximum duration of viral detection was 15days for 
      HSV and 12days for VZV, respectively. This suggests that the detection of HSV, 
      VZV, CMV, and EV strongly indicates symptomatic viral CNS disease. Secondary 
      viral reactivation mostly underlies positive EBV and HHV-6 findings. Their 
      detection does not rule out clinical impact but recommends searching for 
      additional underlying conditions.
CI  - Copyright (c) 2014 Elsevier Inc. All rights reserved.
FAU - Kleines, Michael
AU  - Kleines M
AD  - Division of Virology, Medical University of Innsbruck, Innsbruck, Austria. 
      Electronic address: mkleines@ukaachen.de.
FAU - Scheithauer, Simone
AU  - Scheithauer S
AD  - Department of Infection Control and Infectious Diseases, RWTH Aachen University 
      Hospital, Aachen, Germany. Electronic address: sscheithauer@ukaachen.de.
FAU - Schiefer, Johannes
AU  - Schiefer J
AD  - Department of Neurology, RWTH Aachen University Hospital, Aachen, Germany. 
      Electronic address: jschiefer@ukaachen.de.
FAU - Hausler, Martin
AU  - Hausler M
AD  - Department of Pediatrics, Division of Pediatric Neurology and Social Pediatrics, 
      RWTH Aachen University Hospital, Aachen, Germany. Electronic address: 
      haeusler@rwth-aachen.de.
LA  - eng
PT  - Journal Article
DEP - 20140806
PL  - United States
TA  - Diagn Microbiol Infect Dis
JT  - Diagnostic microbiology and infectious disease
JID - 8305899
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Central Nervous System Diseases/*diagnosis
MH  - Cerebrospinal Fluid/*virology
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Middle Aged
MH  - Molecular Diagnostic Techniques/*methods
MH  - Polymerase Chain Reaction/*methods
MH  - Retrospective Studies
MH  - Virus Diseases/*diagnosis
MH  - Viruses/classification/*isolation & purification
MH  - Young Adult
OTO - NOTNLM
OT  - Cerebrospinal fluid analysis
OT  - Cytomegalovirus
OT  - Enteroviruses
OT  - Epstein-Barr virus
OT  - Herpes simplex virus
OT  - Human herpesvirus type 6
OT  - Human immunodeficiency virus infection
OT  - PCR
OT  - Stroke
OT  - Virobiome
EDAT- 2014/09/03 06:00
MHDA- 2015/07/15 06:00
CRDT- 2014/09/03 06:00
PHST- 2013/12/06 00:00 [received]
PHST- 2014/07/27 00:00 [revised]
PHST- 2014/07/28 00:00 [accepted]
PHST- 2014/09/03 06:00 [entrez]
PHST- 2014/09/03 06:00 [pubmed]
PHST- 2015/07/15 06:00 [medline]
AID - S0732-8893(14)00316-2 [pii]
AID - 10.1016/j.diagmicrobio.2014.07.010 [doi]
PST - ppublish
SO  - Diagn Microbiol Infect Dis. 2014 Nov;80(3):207-15. doi: 
      10.1016/j.diagmicrobio.2014.07.010. Epub 2014 Aug 6.