Detection of both herpes simplex and varicella-zoster viruses in cerebrospinal fluid from patients with encephalitis

✍ Scribed by Casas, Inmaculada; Tenorio, Antonio; de Ory, Fernando; Lozano, Alvaro; Echevarría, José Manuel

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 910 KB
• Volume: 50
• Category: Article
• ISSN: 0146-6615
• DOI: 10.1002/(sici)1096-9071(199609)50:1<82::aid-jmv14>3.0.co;2-#

✦ Synopsis

Cerebrospinal fluid (CSF) samples from 46 patients with encephalitis were studied f o r t h e presence of herpes simplex virus (HSV) types 1 and 2 and/or varicella zoster virus (VZV)-specific DNA sequences by the polymerase chain reaction (PCR) assay. Patients were studied because of detection of intrathecal production of IgG antibody t o HSV alone (10 patients, Group A) or t o both HSV and VZV ( 1 1 patients, Group B) or because of the presence of specific anti-HSV IgG in CSF without evidence of intrathecal antibody production (25 patients, Group C). CSF samples taken between days 1 and 10 f r o m onset of encephalitis were available f r o m all patients, and follow-up samples (taken after 10 days from onset) were obtained from some of them. Positive PCR results were obtained in a total of 13 patients. Four patients (three f r o m Group A and one f r o m Group B) gave amplification of HSV type 1 DNA alone, t w o patients (both from Group B) showed amplification of VZV DNA alone, and seven patients (all from Group B) gave dual amplification of both HSV type 1 and VZV DNA sequences in CSF. All CSF samples f r o m patients in Group C were negative by PCR. Ten patients with CSF samples positive by PCR lacked a prior history o f herpetic cutaneous lesions. In seven patients, serum antibody tests (specific I g M detection and specific IgG avidity assays) identified both primary and recurrent infections. The results suggest that the dual presence of IgG antibody to both HSV and VZV i n CSF from patients with encephalitis may reflect in some cases a dual infection o f the central nervous system caused by both agents.