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Positive CSF HSV PCR in patients with GBM: a note of caution

S S McDermott1, P F McDermott, J Skare

  • 1Department of Neurology, University of Massachusetts Medical School, Worcester, MA, USA.

Neurology
|February 19, 2000
PubMed

Insights

Herpes simplex virus (HSV) DNA detection in cerebrospinal fluid (CSF) via PCR for temporal lobe glioblastoma patients may yield false positives. Diagnosis of herpes simplex encephalitis (HSE) requires more than PCR alone, especially with atypical presentations.

Area of Science:

  • Neuro-oncology
  • Viral diagnostics
  • Molecular pathology

Background:

  • Temporal lobe glioblastomas present diagnostic challenges.
  • Polymerase chain reaction (PCR) is a sensitive method for detecting viral DNA.
  • Herpes simplex virus (HSV) can cause central nervous system infections.

Observation:

  • Two patients with temporal lobe glioblastomas showed HSV DNA in CSF via PCR.
  • A review of 159 frozen CSF samples from patients with glioblastoma multiforme and other neurological disorders was conducted.
  • HSV DNA was not detected in any other tumor samples analyzed.

Findings:

  • The positive HSV PCR results in the two index patients were deemed most likely false-positive.
  • PCR detection of HSV in CSF from glioblastoma patients may not indicate active HSV infection.
  • Inability to detect HSV in other tumor samples supports the false-positive conclusion.

Implications:

  • A diagnosis of herpes simplex encephalitis (HSE) should not rely solely on PCR detection of HSV DNA.
  • Clinical presentation is critical when interpreting PCR results for HSV in neurological disorders.
  • Atypical presentations require cautious interpretation of molecular diagnostic data to avoid misdiagnosis.

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