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Diagnosis of enteroviral central nervous system infection by polymerase chain reaction during a large community
M H Sawyer1, D Holland, N Aintablian
1University of California, San Diego, La Jolla 92093.
Abstract:
Enteroviruses are common causes of localized and systemic infection in patients of all ages and are the most frequent cause of epidemic aseptic meningitis in the United States. We have developed a polymerase chain reaction (PCR) assay of cerebrospinal fluid (CSF) for rapid diagnosis of enteroviral meningitis. This assay was applied to 257 CSF specimens during a large community outbreak of enterovirus disease; 109 (97%) of 112 enterovirus culture-positive CSF samples contained enterovirus RNA. In addition 35 (66%) of 53 samples from patients with suspected central nervous system disease with negative or no CSF viral cultures were positive by enterovirus PCR. The enterovirus PCR detected 13 different enterovirus serotypes. PCR results are available within 24 hours compared with a mean of 6.8 days for enterovirus culture. The clinical characteristics of 141 patients with enterovirus central nervous system disease are presented. This study demonstrates the usefulness of enterovirus PCR for the rapid diagnosis of enterovirus central nervous system disease and the potential for PCR tests to shorten hospitalization.
Insights
Polymerase chain reaction (PCR) offers rapid diagnosis for enteroviral meningitis, detecting 13 serotypes in cerebrospinal fluid. This molecular assay significantly speeds up diagnosis compared to traditional culture methods.
Area of Science:
- Virology
- Molecular Biology
- Infectious Diseases
Background:
- Enteroviruses are frequent causes of infection and the leading cause of aseptic meningitis in the US.
- Rapid and accurate diagnosis of enteroviral meningitis is crucial for patient management.
Purpose of the Study:
- To develop and evaluate a polymerase chain reaction (PCR) assay for the rapid diagnosis of enteroviral meningitis using cerebrospinal fluid (CSF).
Main Methods:
- A PCR assay was developed for enterovirus detection in CSF specimens.
- The assay was applied to 257 CSF samples during a community outbreak.
- Results were compared with conventional enterovirus culture methods.
Main Results:
- The PCR assay detected enterovirus RNA in 97% of culture-positive CSF samples (109/112).
- It identified enterovirus in 66% of suspected cases with negative or no viral cultures (35/53).
- PCR results were available within 24 hours, significantly faster than the 6.8-day mean for culture.
Conclusions:
- Enterovirus PCR is a valuable tool for the rapid diagnosis of central nervous system enterovirus disease.
- This diagnostic approach has the potential to reduce patient hospitalization duration.