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Virological testing of cerebrospinal fluid in children aged less than 14 years with a suspected central nervous system infection: A retrospective study on 304 consecutive children from January 2012 to May 2015.
Eur J Paediatr Neurol. 2016 Jul; 20(4):588-96.EJ

Abstract

OBJECTIVE

The study aimed to describe the prevalence of HSV DNA, VZV DNA, Enterovirus RNA, Parechovirus RNA, CMV DNA, EBV DNA, adenovirus DNA, HHV-6 DNA, HHV-7 DNA, HHV-8 DNA and Parvovirus B19DNA in children aged less 14 years with a suspected viral infection of the central nervous system in a clinical practice setting.

METHODS

Between January 2012 and May 2015, cerebrospinal fluids from 304 children were tested with an in-house real-time PCR method.

RESULTS

A positive PCR was detected in 64 subjects (21%): the mean number of tests performed in patients who showed a viral infection was 7.5, significantly higher (p = 0.001) with respect to that reported in negative samples (6.4). Enterovirus is the leading virus detected: 12 out of the 37 positive children reported were newborns (85.7% of all the newborns with a positive result). The second most frequently identified virus was HHV-7 (5 positive PCR out of 105 samples tested, 4.8%, if we excluded a child with a concomitant S. pneumoniae isolated), a prevalence significantly higher with respect to VZV (p = 0.02) and to CMV (p = 0.04). HHV-6 was the third most commonly identified aetiology (4.2%). All children were immunocompetent.

SIGNIFICANCE

Only a minority of children had a specific viral aetiology identified: the rate of HHV-7 positivity suggests a routine testing of these viruses within the diagnostic algorithm in immunocompetent paediatric patients. This approach could help to define the clinical role of this herpesvirus.

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Authors+Show Affiliations

Parisi SG
Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy; Microbiology and Virology Unit, Padova University Hospital, Indirizzo: Via Giustiniani, 2, 35128 Padova, Italy. Electronic address: saverio.parisi@unipd.it.
Basso M
Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy; Microbiology and Virology Unit, Padova University Hospital, Indirizzo: Via Giustiniani, 2, 35128 Padova, Italy.
Del Vecchio C
Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy; Microbiology and Virology Unit, Padova University Hospital, Indirizzo: Via Giustiniani, 2, 35128 Padova, Italy.
Andreis S
Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy.
Franchin E
Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy; Microbiology and Virology Unit, Padova University Hospital, Indirizzo: Via Giustiniani, 2, 35128 Padova, Italy.
Bello FD
Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy; Microbiology and Virology Unit, Padova University Hospital, Indirizzo: Via Giustiniani, 2, 35128 Padova, Italy.
Pagni S
Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy; Microbiology and Virology Unit, Padova University Hospital, Indirizzo: Via Giustiniani, 2, 35128 Padova, Italy.
Biasolo MA
Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy; Microbiology and Virology Unit, Padova University Hospital, Indirizzo: Via Giustiniani, 2, 35128 Padova, Italy.
Manganelli R
Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy; Microbiology and Virology Unit, Padova University Hospital, Indirizzo: Via Giustiniani, 2, 35128 Padova, Italy.
Barzon L
Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy; Microbiology and Virology Unit, Padova University Hospital, Indirizzo: Via Giustiniani, 2, 35128 Padova, Italy.
Palù G
Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy; Microbiology and Virology Unit, Padova University Hospital, Indirizzo: Via Giustiniani, 2, 35128 Padova, Italy.

MeSH

AdenoviridaeAdenoviridae InfectionsCentral Nervous System InfectionsChildChild, PreschoolCytomegalovirusCytomegalovirus InfectionsDNA, ViralEncephalitis, Herpes SimplexEncephalitis, Varicella ZosterEnterovirusEnterovirus InfectionsEpstein-Barr Virus InfectionsFemaleHerpes SimplexHerpesviridae InfectionsHerpesvirus 3, HumanHerpesvirus 4, HumanHerpesvirus 6, HumanHerpesvirus 7, HumanHerpesvirus 8, HumanHumansInfant, NewbornItalyMaleParechovirusParvoviridae InfectionsParvovirus B19, HumanPicornaviridae InfectionsPrevalenceRNA, ViralReal-Time Polymerase Chain ReactionRetrospective StudiesRoseolovirus InfectionsVirus Diseases

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27129875

Citation

Parisi, Saverio G., et al. "Virological Testing of Cerebrospinal Fluid in Children Aged Less Than 14 Years With a Suspected Central Nervous System Infection: a Retrospective Study On 304 Consecutive Children From January 2012 to May 2015." European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society, vol. 20, no. 4, 2016, pp. 588-96.
Parisi SG, Basso M, Del Vecchio C, et al. Virological testing of cerebrospinal fluid in children aged less than 14 years with a suspected central nervous system infection: A retrospective study on 304 consecutive children from January 2012 to May 2015. Eur J Paediatr Neurol. 2016;20(4):588-96.
Parisi, S. G., Basso, M., Del Vecchio, C., Andreis, S., Franchin, E., Bello, F. D., Pagni, S., Biasolo, M. A., Manganelli, R., Barzon, L., & Palù, G. (2016). Virological testing of cerebrospinal fluid in children aged less than 14 years with a suspected central nervous system infection: A retrospective study on 304 consecutive children from January 2012 to May 2015. European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society, 20(4), 588-96. https://doi.org/10.1016/j.ejpn.2016.04.002
Parisi SG, et al. Virological Testing of Cerebrospinal Fluid in Children Aged Less Than 14 Years With a Suspected Central Nervous System Infection: a Retrospective Study On 304 Consecutive Children From January 2012 to May 2015. Eur J Paediatr Neurol. 2016;20(4):588-96. PubMed PMID: 27129875.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Virological testing of cerebrospinal fluid in children aged less than 14 years with a suspected central nervous system infection: A retrospective study on 304 consecutive children from January 2012 to May 2015. AU - Parisi,Saverio G, AU - Basso,Monica, AU - Del Vecchio,Claudia, AU - Andreis,Samantha, AU - Franchin,Elisa, AU - Bello,Federico Dal, AU - Pagni,Silvana, AU - Biasolo,Maria Angela, AU - Manganelli,Riccardo, AU - Barzon,Luisa, AU - Palù,Giorgio, Y1 - 2016/04/16/ PY - 2015/10/28/received PY - 2016/04/05/revised PY - 2016/04/06/accepted PY - 2016/5/1/entrez PY - 2016/5/1/pubmed PY - 2016/12/15/medline KW - CSF KW - HHV-7 KW - In house real time PCR SP - 588 EP - 96 JF - European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society JO - Eur J Paediatr Neurol VL - 20 IS - 4 N2 - OBJECTIVE: The study aimed to describe the prevalence of HSV DNA, VZV DNA, Enterovirus RNA, Parechovirus RNA, CMV DNA, EBV DNA, adenovirus DNA, HHV-6 DNA, HHV-7 DNA, HHV-8 DNA and Parvovirus B19DNA in children aged less 14 years with a suspected viral infection of the central nervous system in a clinical practice setting. METHODS: Between January 2012 and May 2015, cerebrospinal fluids from 304 children were tested with an in-house real-time PCR method. RESULTS: A positive PCR was detected in 64 subjects (21%): the mean number of tests performed in patients who showed a viral infection was 7.5, significantly higher (p = 0.001) with respect to that reported in negative samples (6.4). Enterovirus is the leading virus detected: 12 out of the 37 positive children reported were newborns (85.7% of all the newborns with a positive result). The second most frequently identified virus was HHV-7 (5 positive PCR out of 105 samples tested, 4.8%, if we excluded a child with a concomitant S. pneumoniae isolated), a prevalence significantly higher with respect to VZV (p = 0.02) and to CMV (p = 0.04). HHV-6 was the third most commonly identified aetiology (4.2%). All children were immunocompetent. SIGNIFICANCE: Only a minority of children had a specific viral aetiology identified: the rate of HHV-7 positivity suggests a routine testing of these viruses within the diagnostic algorithm in immunocompetent paediatric patients. This approach could help to define the clinical role of this herpesvirus. SN - 1532-2130 UR - https://www.unboundmedicine.com/medline/citation/27129875/Virological_testing_of_cerebrospinal_fluid_in_children_aged_less_than_14_years_with_a_suspected_central_nervous_system_infection:_A_retrospective_study_on_304_consecutive_children_from_January_2012_to_May_2015_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1090-3798(16)30005-8 DB - PRIME DP - Unbound Medicine ER -