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Diagnosis of enteroviral meningitis by use of polymerase chain reaction of cerebrospinal fluid, stool, and serum specimens.
Clin Infect Dis. 2005 Apr 01; 40(7):982-7.CI

Abstract

BACKGROUND

Because enteroviruses can be detected in various clinical samples during enteroviral meningitis, we analyzed the combined diagnostic utility of polymerase chain reaction (PCR) of cerebrospinal fluid (CSF), feces, and serum for detection of enterovirus in specimens obtained from adults with aseptic meningitis or encephalitis.

METHODS

PCR results were analyzed for 34 adults for whom enteroviral meningitis was diagnosed on the basis of virus isolation and antibody detection in our hospital during 1999-2003. PCR results were also analyzed for 77 adults with meningitis or encephalitis of another defined cause for whom this assay was used for diagnostic evaluation during that period.

RESULTS

Twenty-six (76%) of 34 CSF samples and 24 (96%) of 25 fecal samples collected from patients with enteroviral meningitis had positive PCR results. The diagnostic yield of the test was lower for CSF specimens obtained >2 days after clinical onset, compared with CSF collected < or =2 days after onset. Instead, PCR of feces was highly useful also later, because 12 of the 13 fecal specimens obtained 5-16 days after clinical onset had positive test results. None of 75 CSF samples and 2 of 48 fecal samples obtained from patients with nonenteroviral infection had positive PCR results. All serum samples were PCR negative.

CONCLUSIONS

PCR of fecal specimens obtained throughout the course of enteroviral meningitis had the highest clinical sensitivity for detecting enterovirus. It is recommended that, in addition to performance of CSF PCR, fecal samples collected from patients with suspected enteroviral meningitis should be tested by PCR, especially when the duration of symptoms is >2 days.

Authors+Show Affiliations

Department of Neurology, Turku University Central Hospital, Turku, Finland. laura.kupila@tyks.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15824990

Citation

Kupila, Laura, et al. "Diagnosis of Enteroviral Meningitis By Use of Polymerase Chain Reaction of Cerebrospinal Fluid, Stool, and Serum Specimens." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 40, no. 7, 2005, pp. 982-7.
Kupila L, Vuorinen T, Vainionpäā R, et al. Diagnosis of enteroviral meningitis by use of polymerase chain reaction of cerebrospinal fluid, stool, and serum specimens. Clin Infect Dis. 2005;40(7):982-7.
Kupila, L., Vuorinen, T., Vainionpäā, R., Marttila, R. J., & Kotilainen, P. (2005). Diagnosis of enteroviral meningitis by use of polymerase chain reaction of cerebrospinal fluid, stool, and serum specimens. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 40(7), 982-7.
Kupila L, et al. Diagnosis of Enteroviral Meningitis By Use of Polymerase Chain Reaction of Cerebrospinal Fluid, Stool, and Serum Specimens. Clin Infect Dis. 2005 Apr 1;40(7):982-7. PubMed PMID: 15824990.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosis of enteroviral meningitis by use of polymerase chain reaction of cerebrospinal fluid, stool, and serum specimens. AU - Kupila,Laura, AU - Vuorinen,Tytti, AU - Vainionpäā,Raija, AU - Marttila,Reijo J, AU - Kotilainen,Pirkko, Y1 - 2005/03/04/ PY - 2004/09/27/received PY - 2004/11/22/accepted PY - 2005/4/13/pubmed PY - 2006/7/25/medline PY - 2005/4/13/entrez SP - 982 EP - 7 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 40 IS - 7 N2 - BACKGROUND: Because enteroviruses can be detected in various clinical samples during enteroviral meningitis, we analyzed the combined diagnostic utility of polymerase chain reaction (PCR) of cerebrospinal fluid (CSF), feces, and serum for detection of enterovirus in specimens obtained from adults with aseptic meningitis or encephalitis. METHODS: PCR results were analyzed for 34 adults for whom enteroviral meningitis was diagnosed on the basis of virus isolation and antibody detection in our hospital during 1999-2003. PCR results were also analyzed for 77 adults with meningitis or encephalitis of another defined cause for whom this assay was used for diagnostic evaluation during that period. RESULTS: Twenty-six (76%) of 34 CSF samples and 24 (96%) of 25 fecal samples collected from patients with enteroviral meningitis had positive PCR results. The diagnostic yield of the test was lower for CSF specimens obtained >2 days after clinical onset, compared with CSF collected < or =2 days after onset. Instead, PCR of feces was highly useful also later, because 12 of the 13 fecal specimens obtained 5-16 days after clinical onset had positive test results. None of 75 CSF samples and 2 of 48 fecal samples obtained from patients with nonenteroviral infection had positive PCR results. All serum samples were PCR negative. CONCLUSIONS: PCR of fecal specimens obtained throughout the course of enteroviral meningitis had the highest clinical sensitivity for detecting enterovirus. It is recommended that, in addition to performance of CSF PCR, fecal samples collected from patients with suspected enteroviral meningitis should be tested by PCR, especially when the duration of symptoms is >2 days. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/15824990/Diagnosis_of_enteroviral_meningitis_by_use_of_polymerase_chain_reaction_of_cerebrospinal_fluid_stool_and_serum_specimens_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/428581 DB - PRIME DP - Unbound Medicine ER -