Sauerbrei & Wutzler (2002). Laboratory diagnosis of central nervous system infections caused by herpesviruses.

Wise Young · 05-03-2003, 06:30 AM

• Sauerbrei A and Wutzler P (2002). Laboratory diagnosis of central nervous system infections caused by herpesviruses. J Clin Virol 25 Suppl 1:S45-51. Summary: BACKGROUND: Herpesviruses may be associated with various types of central nervous system (CNS) infections. Herpes simplex encephalitis (HSE) has to be considered one of the most severe diseases. As effective antiviral drugs are available, rapid and reliable diagnosis has become important. OBJECTIVES: To describe polymerase chain reaction (PCR) and serological methods for the detection of herpesvirus-induced CNS infections by the example of HSE. STUDY DESIGN: 620 cerebrospinal fluid (CSF) and 2400 serum samples from 2700 selected hospitalized patients with clinical suspicion of encephalitis were tested for herpes simplex virus (HSV) as well as varicella-zoster virus (VZV) DNA and HSV-specific antibodies, respectively. RESULTS: HSV-1 DNA could be detected in eight and HSV-2 in three patients with focal encephalitis. In addition, HSV-2 DNA was found in two newborns with encephalitis and two adults suffered from transverse lumbar myelitis. One VZV DNA-positive patient had developed herpes zoster accompanied by meningoencephalitis, and in the other an encephalitis without cutaneous rash was diagnosed. Intrathecal antibody synthesis could be measured when CSF was cleared from viral DNA. CONCLUSIONS: The detection of viral DNA by PCR technique has become the "gold standard" method for laboratory diagnosis of herpesvirus infections of CNS. Serodiagnosis may be useful to confirm the diagnosis retrospectively. Institute for Antiviral Chemotherapy, Friedrich-Schiller University Jena, Winzerlaer Stasse 10, D-07745 Jena, Germany. andreas.sauerbrei@med.uni-jena.de

Wise Young · 05-03-2003, 06:39 AM

• Kusuhara T, Nakajima M, Inoue H, Takahashi M and Yamada T (2002). Parainfectious encephalomyeloradiculitis associated with herpes simplex virus 1 DNA in cerebrospinal fluid. Clin Infect Dis 34:1199-205. Summary: We describe a patient with acute encephalomyeloradiculitis associated with herpes simplex virus 1 (HSV-1) DNA in the cerebrospinal fluid (CSF), and we also review 4 similar cases previously reported from Japan. A 59-year-old man presented with acute encephalitis and urinary retention. Initially, coma and CSF pleocytosis improved with acyclovir treatment, but brain stem encephalitis, transverse myelitis, and lumbosacral polyradiculitis subsequently occurred. These conditions responded to corticosteroid therapy and immunoadsorption plasmapheresis. Polymerase chain reaction detected HSV-1 DNA in the CSF during acute encephalitis but not thereafter. Serial magnetic resonance imaging revealed transient lesions in the thalamus and basal ganglia on both sides of the brain and in the pons, spinal cord, and cauda equina. Acute encephalomyeloradiculitis is a unique neurological syndrome that may be caused by HSV-1 infection of the central nervous system. Department of Neurology, School of Medicine, Fukuoka University, Fukuoka, Japan 814-0180.

05-03-2003, 06:30 AM	#1
Wise Young Administrator Join Date: Jul 2001 Location: New Brunswick, NJ, USA Posts: 37,975	Sauerbrei & Wutzler (2002). Laboratory diagnosis of central nervous system infections caused by herpesviruses. • Sauerbrei A and Wutzler P (2002). Laboratory diagnosis of central nervous system infections caused by herpesviruses. J Clin Virol 25 Suppl 1:S45-51. Summary: BACKGROUND: Herpesviruses may be associated with various types of central nervous system (CNS) infections. Herpes simplex encephalitis (HSE) has to be considered one of the most severe diseases. As effective antiviral drugs are available, rapid and reliable diagnosis has become important. OBJECTIVES: To describe polymerase chain reaction (PCR) and serological methods for the detection of herpesvirus-induced CNS infections by the example of HSE. STUDY DESIGN: 620 cerebrospinal fluid (CSF) and 2400 serum samples from 2700 selected hospitalized patients with clinical suspicion of encephalitis were tested for herpes simplex virus (HSV) as well as varicella-zoster virus (VZV) DNA and HSV-specific antibodies, respectively. RESULTS: HSV-1 DNA could be detected in eight and HSV-2 in three patients with focal encephalitis. In addition, HSV-2 DNA was found in two newborns with encephalitis and two adults suffered from transverse lumbar myelitis. One VZV DNA-positive patient had developed herpes zoster accompanied by meningoencephalitis, and in the other an encephalitis without cutaneous rash was diagnosed. Intrathecal antibody synthesis could be measured when CSF was cleared from viral DNA. CONCLUSIONS: The detection of viral DNA by PCR technique has become the "gold standard" method for laboratory diagnosis of herpesvirus infections of CNS. Serodiagnosis may be useful to confirm the diagnosis retrospectively. Institute for Antiviral Chemotherapy, Friedrich-Schiller University Jena, Winzerlaer Stasse 10, D-07745 Jena, Germany. andreas.sauerbrei@med.uni-jena.de

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05-03-2003, 06:39 AM	#2
Wise Young Administrator Join Date: Jul 2001 Location: New Brunswick, NJ, USA Posts: 37,975	• Kusuhara T, Nakajima M, Inoue H, Takahashi M and Yamada T (2002). Parainfectious encephalomyeloradiculitis associated with herpes simplex virus 1 DNA in cerebrospinal fluid. Clin Infect Dis 34:1199-205. Summary: We describe a patient with acute encephalomyeloradiculitis associated with herpes simplex virus 1 (HSV-1) DNA in the cerebrospinal fluid (CSF), and we also review 4 similar cases previously reported from Japan. A 59-year-old man presented with acute encephalitis and urinary retention. Initially, coma and CSF pleocytosis improved with acyclovir treatment, but brain stem encephalitis, transverse myelitis, and lumbosacral polyradiculitis subsequently occurred. These conditions responded to corticosteroid therapy and immunoadsorption plasmapheresis. Polymerase chain reaction detected HSV-1 DNA in the CSF during acute encephalitis but not thereafter. Serial magnetic resonance imaging revealed transient lesions in the thalamus and basal ganglia on both sides of the brain and in the pons, spinal cord, and cauda equina. Acute encephalomyeloradiculitis is a unique neurological syndrome that may be caused by HSV-1 infection of the central nervous system. Department of Neurology, School of Medicine, Fukuoka University, Fukuoka, Japan 814-0180.