Viral detection in cerebrospinal fluid (CSF) samples of patients with central nervous system (CNS) infection by molecular

Author(s)

Torres, Laura Patricia Mendoza

• Document type: Master's Dissertation
• Press: Ribeirão Preto. [2005]. 71 f.
• Institution: Universidade de São Paulo (USP). Faculdade de Medicina de Ribeirão Preto
• Defense date: 30 maio 2005

Examining board members

Figueiredo, Luiz Tadeu Moraes; Arruda Neto, Eurico; Pinto, Aramis Augusto

• Advisor: Figueiredo, Luiz Tadeu Moraes
• Field of knowledge: Biological Sciences - Microbiology
• Indexed in: Banco de Dados Bibliográficos da USP-DEDALUS
• Location: Universidade de São Paulo. Biblioteca Central do Campus de Ribeirão Preto; FMRP/Torres, Laura Patricia Mendoza

Abstract

Laboratory diagnosis of viral infections of the CNS was carried out using the polymerase chain reaction (PCR). Virus genome detection was performed in 200 CSF samples by Multiplex-PCR (M-PCR) for Herpesviridae, by RT-nested-PCR (RT-N-PCR) for Enteroviruses and by Multiplex-RT-nested-PCR (M-RT-N-PCR) for Alphabiruses an Flavibiruses. CSF samples were collected from clinical suspected cases of meningitis, encephalitis, meningoencephalitis, polyneuritis and myelitis. Viral nucleic acid was detected in 43 (23.34%) CSF samples, including Enterovirus in 22/194 (11.34%); CMVin 12/200 (6%); HSV-1 in 10/200 (5%); VZV and EBV in 1/200 (0.5%) samples each. Co-infections, CMV - Enterovirus and CMV - HSV-1 were found in three patients. None of the tested samples was positive for Alphavirus and Flavivirus. CNS viral infections were detected in patients at all ages. Enteroviruses were the viruses more frequentlly detected. These viruses are commonly underestimated as causatives of CNS infections in adults. CMV was commonly detected in patients infected with HIV. The 5 observed fatal cases were infected by HIV and had Herpesviridae detected in CSF. Encephalitis and meningoencephalitis were more frequency observed among 8/10 (80%) patients having HSV-1 infection of CNS. CSF parameters such as cytology, protein level and glucose level were normal in many patients having virus detected in the CNS. It shows that a strict analysis of these parameters could not be reliable to discard a CNS viral infection. Our results suggest that the M-PCR, the RT-N-PCR and the M-RT-N-PCR can, therefore, provide an early, rapid and reliable diagnostic tool that could be used as a routine diagnostic test of viral infections of the nervous system. (AU)

• FAPESP's process: 03/05292-8 - Development of multiplex-PCR and multiplex RT-PCR for the diagnosis of viral meningoencephalitis
• Grantee: Laura Patricia Mendoza Torres
• Support type: Scholarships in Brazil - Master