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[Value of polymerase chain reaction in serum for the diagnosis of enteroviral meningitis].
Arch Pediatr. 2013 Jun; 20(6):589-93.AP

Abstract

Enteroviruses (EV) are a common cause of aseptic meningitis in children. Virological diagnosis of EV meningitis is currently based on the detection of the viral genome in the cerebrospinal fluid (CSF). This study attempted to determine the correlation and the temporality of the polymerase chain reaction (PCR) assay in serum and CSF and to evaluate the possibility of diagnosing EV infection only on the serum PCR. The EV genome was sought by RT real-time PCR (Smart Cycler EV Primer and Probe Set(®), Cepheid) in CSF and serum, collected at the same time, for all children who underwent a lumbar puncture for suspected meningitis, between 1 June and 31 July 2010 at the Versailles Hospital. Forty-four patients were included in the study. EV infection was documented for 22 of them. In 10 patients, the EV genome was detected in CSF only; in 3 patients in serum only, and in 9 patients in both. Among patients with acute EV neurological infection, viremic children were significantly younger (1.6 months versus 5.8 years; P<0.001). Viremia was detected when the serum was sampled within 30 h after the beginning of symptoms. These results confirm previous reports of early and transient viremia in young children. This preliminary study shows the limits and added value of EV PCR in serum. It suggests that in some children and under certain conditions (age >3 months, clinical and biological compatibility with a viral infection, no previous antibiotic therapy, time from symptom onset to blood sampling <30 h, PCR in serum analyzed within 3h), PCR in serum, when positive, is a possible alternative. Therefore, it may be possible to diagnose EV infection without performing a lumbar puncture in a limited number of young children (11.4% of our suspected cases). This study needs to be reinforced by a multicenter study with a broader panel of patients.

Authors+Show Affiliations

Laboratoire de microbiologie du département de biologie, hôpital André-Mignot, centre hospitalier de Versailles, 177, rue de Versailles, 78157 Le Chesnay, France. smarquejuillet@ch-versailles.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

23628121

Citation

Marque Juillet, S, et al. "[Value of Polymerase Chain Reaction in Serum for the Diagnosis of Enteroviral Meningitis]." Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, vol. 20, no. 6, 2013, pp. 589-93.
Marque Juillet S, Lion M, Pilmis B, et al. [Value of polymerase chain reaction in serum for the diagnosis of enteroviral meningitis]. Arch Pediatr. 2013;20(6):589-93.
Marque Juillet, S., Lion, M., Pilmis, B., Tomini, E., Dommergues, M. A., Laporte, S., & Foucaud, P. (2013). [Value of polymerase chain reaction in serum for the diagnosis of enteroviral meningitis]. Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, 20(6), 589-93. https://doi.org/10.1016/j.arcped.2013.03.012
Marque Juillet S, et al. [Value of Polymerase Chain Reaction in Serum for the Diagnosis of Enteroviral Meningitis]. Arch Pediatr. 2013;20(6):589-93. PubMed PMID: 23628121.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Value of polymerase chain reaction in serum for the diagnosis of enteroviral meningitis]. AU - Marque Juillet,S, AU - Lion,M, AU - Pilmis,B, AU - Tomini,E, AU - Dommergues,M-A, AU - Laporte,S, AU - Foucaud,P, Y1 - 2013/04/28/ PY - 2012/01/05/received PY - 2013/02/08/revised PY - 2013/03/10/accepted PY - 2013/5/1/entrez PY - 2013/5/1/pubmed PY - 2013/11/6/medline SP - 589 EP - 93 JF - Archives de pediatrie : organe officiel de la Societe francaise de pediatrie JO - Arch Pediatr VL - 20 IS - 6 N2 - Enteroviruses (EV) are a common cause of aseptic meningitis in children. Virological diagnosis of EV meningitis is currently based on the detection of the viral genome in the cerebrospinal fluid (CSF). This study attempted to determine the correlation and the temporality of the polymerase chain reaction (PCR) assay in serum and CSF and to evaluate the possibility of diagnosing EV infection only on the serum PCR. The EV genome was sought by RT real-time PCR (Smart Cycler EV Primer and Probe Set(®), Cepheid) in CSF and serum, collected at the same time, for all children who underwent a lumbar puncture for suspected meningitis, between 1 June and 31 July 2010 at the Versailles Hospital. Forty-four patients were included in the study. EV infection was documented for 22 of them. In 10 patients, the EV genome was detected in CSF only; in 3 patients in serum only, and in 9 patients in both. Among patients with acute EV neurological infection, viremic children were significantly younger (1.6 months versus 5.8 years; P<0.001). Viremia was detected when the serum was sampled within 30 h after the beginning of symptoms. These results confirm previous reports of early and transient viremia in young children. This preliminary study shows the limits and added value of EV PCR in serum. It suggests that in some children and under certain conditions (age >3 months, clinical and biological compatibility with a viral infection, no previous antibiotic therapy, time from symptom onset to blood sampling <30 h, PCR in serum analyzed within 3h), PCR in serum, when positive, is a possible alternative. Therefore, it may be possible to diagnose EV infection without performing a lumbar puncture in a limited number of young children (11.4% of our suspected cases). This study needs to be reinforced by a multicenter study with a broader panel of patients. SN - 1769-664X UR - https://www.unboundmedicine.com/medline/citation/23628121/[Value_of_polymerase_chain_reaction_in_serum_for_the_diagnosis_of_enteroviral_meningitis]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0929-693X(13)00228-5 DB - PRIME DP - Unbound Medicine ER -