Clinical Microbiology Newsletter
Volume 32, Issue 3 , Pages 17-23 , 1 February 2010

Diagnostic Testing for Encephalitis, Part I

  • Julie E. Reznicek, D.O.

      Affiliations

    • Department of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee
  • ,
  • Karen C. Bloch, M.D.

      Affiliations

    • Departments of Medicine and Preventive Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee

References 

  1. Roos KL . Encephalitis . Neurol. Clin. . 1999;17:813–833
  2. Solomon T , Hart IJ , Beeching NJ . Viral encephalitis: a clinician's guide . Pract. Neurol. . 2007;7:288–305
  3. Whitley RJ , Gnann JW . Viral encephalitis: familiar infections and emerging pathogens . Lancet . 2002;359:507–513
  4. Romero JR , Newland JG . Viral meningitis and encephalitis: traditional and emerging viral agents . Semin. Pediatr. Infect. Dis. . 2003;14:72–82
  5. Glaser CA , et al.   Beyond viruses: clinical profiles and etiologies associated with encephalitis . Clin. Infect. Dis. . 2006;43:1565–1577
  6. Garg RK . Acute disseminated encephalomyelitis . Postgrad. Med. J. . 2003;79:11–17
  7. Young NP , Weinshenker BG , Lucchinetti CF . Acute disseminated encephalomyelitis: current understanding and controversies . Semin. Neurol. . 2008;28:84–94
  8. Beghi E , et al.   Encephalitis and aseptic meningitis, Olmsted County, Minnesota, 1950–1981: I. Epidemiology . Ann. Neurol. . 1984;16:283–294
  9. Khetsuriani N , Holman RC , Anderson LJ . Burden of encephalitis-associated hospitalizations in the United States, 1988–1997 . Clin. Infect. Dis. . 2002;35:175–182
  10. Koskiniemi M , Vaheri A . Effect of measles, mumps, rubella vaccination on pattern of encephalitis in children . Lancet . 1989;i:31–34
  11. Tunkel AR , et al.   The management of encephalitis: clinical practice guidelines by the Infectious Diseases Society of America . Clin. Infect. Dis. . 2008;47:303–327
  12. Polage CR , Petti CA . Assessment of the utility of viral culture of cerebrospinal fluid . Clin. Infect. Dis. . 2006;43:1578–1579
  13. Barnett ND , et al.   Primary amoebic meningoencephalitis with Naegleria fowleri: clinical review . Pediatr. Neurol. . 1996;15:230–234
  14. Reiber H , Lange P . Quantification of virus-specific antibodies in cerebrospinal fluid and serum: sensitive and specific detection of antibody synthesis in brain . Clin. Chem. . 1991;37:1153–1160
  15. Monteyne P , et al.   The detection of intrathecal synthesis of anti-herpes simplex IgG antibodies: comparison between an antigen-mediated immunoblotting technique and antibody index calculations. European Union Concerted Action on Virus Meningitis and Encephalitis . J. Med. Virol. . 1997;53:324–331
  16. Steiner I , et al.   Viral encephalitis: a review of diagnostic methods and guidelines for management . Eur. J. Neurol. . 2005;12:331–343
  17. Doong H , et al.   Duplex eQ-PCR for simultaneous detection and differentiation of herpes simplex viruses and enteroviruses in cerebrospinal fluid . Proc. 108th Gen. Meet. Am. Soc. Microbiol. . 2008;
  18. Espy MJ , et al.   Real-time PCR in clinical microbiology: applications for routine laboratory testing . Clin. Microbiol. Rev. . 2006;19:165–256
  19. Lakeman FD , Whitley RJ . Diagnosis of herpes simplex encephalitis: application of polymerase chain reaction to cerebrospinal fluid from brain-biopsied patients and correlation with disease. National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group . J. Infect. Dis. . 1995;171:857–863
  20. Allawi HT , et al.   Invader plus method detects herpes simplex virus in cerebrospinal fluid and simultaneously differentiates types 1 and 2 . J. Clin. Microbiol. . 2006;44:3443–3447
  21. Tang YW , et al.   Comparative evaluation of colorimetric microtiter plate systems for detection of herpes simplex virus in cerebrospinal fluid . J. Clin. Microbiol. . 1998;36:2714–2717
  22. Weinberg A , et al.   Dual infections of the central nervous system with Epstein-Barr virus . J. Infect. Dis. . 2005;191:234–237
  23. Schloss L , et al.   An international external quality assessment of nucleic acid amplification of herpes simplex virus . J. Clin. Virol. . 2003;28:175–185
  24. O'Sullivan, CE , et al.   Clinical spectrum and laboratory characteristics associated with detection of herpes simplex virus DNA in cerebrospinal fluid . Mayo Clin. Proc. . 2003;78:1347–1352
  25. Steiner I , Kennedy PG , Pachner AR . The neurotropic herpes viruses: herpes simplex and varicella-zoster . Lancet Neurol. . 2007;6:1015–1028
  26. Whitley RJ , Lakeman F . Herpes simplex virus infections of the central nervous system: therapeutic and diagnostic considerations . Clin. Infect. Dis. . 1995;20:414–420
  27. Whitley RJ . Herpes simplex encephalitis: adolescents and adults . Antivir. Res. . 2006;71:141–148
  28. Whitley RJ , et al.   Herpes simplex encephalitis. Clinical assessment . JAMA . 1982;247:317–320
  29. Domingues RB , et al.   Diagnosis of herpes simplex encephalitis by magnetic resonance imaging and polymerase chain reaction assay of cerebrospinal fluid . J. Neurol. Sci. . 1998;157:148–153
  30. Tang YW . Laboratory diagnosis of CNS infections by molecular amplification techniques . Exp. Opin. Med. Diagn. . 2007;1:489–509
  31. Tyler KL . Herpes simplex virus infections of the central nervous system: encephalitis and meningitis, including Mollaret's . Herpes . 2004;11(Suppl. 2):57A–64A
  32. Cinque P , et al.   The role of laboratory investigation in the diagnosis and management of patients with suspected herpes simplex encephalitis: a consensus report. The EU Concerted Action on Virus Meningitis and Encephalitis . J. Neurol. Neurosurg. Psychiatry . 1996;61:339–345
  33. Malm G , Forsgren M . Neonatal herpes simplex virus infections: HSV DNA in cerebrospinal fluid and serum . Arch. Dis. Child Fetal Neonatal Ed. . 1999;81:F24–F29
  34. Gilden DH , et al.   Herpesvirus infections of the nervous system . Nat. Clin. Pract. Neurol. . 2007;3:82–94
  35. Zerr DM . Human herpesvirus 6 and central nervous system disease in hematopoietic cell transplantation . J. Clin. Virol. . 2006;37(Suppl. 1):S52–S56
  36. Arribas JR , et al.   Cytomegalovirus encephalitis . Ann. Intern. Med. . 1996;125:577–587
  37. Crawford DH , et al.   A cohort study among university students: identification of risk factors for Epstein-Barr virus seroconversion and infectious mononucleosis . Clin. Infect. Dis. . 2006;43:276–282
  38. Weinberg A , et al.   Quantitative CSF PCR in Epstein-Barr virus infections of the central nervous system . Ann. Neurol. . 2002;52:543–548
  39. Portegies P , Corssmit N . Epstein-Barr virus and the nervous system . Curr. Opin. Neurol. . 2000;13:301–304
  40. Straus SE , et al.   NIH conference. Epstein-Barr virus infections: biology, pathogenesis, and management . Ann. Intern. Med. . 1993;118:45–58
  41. Corcoran C , et al.   The predictive value of cerebrospinal fluid Epstein-Barr viral load as a marker of primary central nervous system lymphoma in HIV-infected persons . J. Clin. Virol. . 2008;42:433–436
  42. Gilden DH , et al.   Neurologic complications of the reactivation of varicella-zoster virus . N. Engl. J. Med. . 2000;342:635–645
  43. Gnann JW . Varicella-zoster virus: atypical presentations and unusual complications . J Infect. Dis. . 2002;186(Suppl. 1):S91–S98
  44. Kleinschmidt-DeMasters, BK , Gilden DH . Varicella-zoster virus infections of the nervous system: clinical and pathologic correlates . Arch. Pathol. Lab. Med. . 2001;125:770–780
  45. Koskiniemi M , et al.   Acute central nervous system complications in varicella zoster virus infections . J. Clin. Virol. . 2002;25:293–301
  46. Gregoire SM , et al.   Polymerase chain reaction analysis and oligoclonal antibody in the cerebrospinal fluid from 34 patients with varicella-zoster virus infection of the nervous system . J. Neurol. Neurosurg. Psychiatry . 2006;77:938–942
  47. Burke DG , et al.   Polymerase chain reaction detection and clinical significance of varicella-zoster virus in cerebrospinal fluid from human immunodeficiency virus-infected patients . J. Infect. Dis. . 1997;176:1080–1084
  48. Modlin JF , et al.   Focal encephalitis with enterovirus infections . Pediatrics . 1991;88:841–845
  49. Rotbart HA . Enteroviral infections of the central nervous system . Clin. Infect. Dis. . 1995;20:971–981
  50. Huang CC , et al.   Neurologic complications in children with enterovirus 71 infection . N. Engl. J. Med. . 1999;341:936–942
  51. Rotbart HA , et al.   Diagnosis of enteroviral meningitis by using PCR with a colorimetric microwell detection assay . J. Clin. Microbiol. . 1994;32:2590–2592
  52. 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;40:982–987
  53. Chung PW , et al.   Duration of enterovirus shedding in stool . J. Microbiol. Immunol. Infect. . 2001;34:167–170
  54. Harrell GT . Rickettsial involvement of the nervous system . Med. Clin. North Am. . 1953;37:395–422
  55. Treadwell TA , et al.   Rocky Mountain spotted fever in the United States, 1993–1996 . Am. J. Trop. Med. Hyg. . 2000;63:21–26
  56. Kirk JL , et al.   Rocky Mountain spotted fever. A clinical review based on 48 confirmed cases, 1943–1986 . Medicine (Baltimore) . 1990;69:35–45
  57. Thorner AR , Walker DH , Petri WA . Rocky mountain spotted fever . Clin. Infect. Dis. . 1998;27:1353–1359
  58. Sexton DJ , Corey GR . Rocky Mountain “spotless” and “almost spotless” fever: a wolf in sheep's clothing . Clin. Infect. Dis. . 1992;15:439–448
  59. Chapman AS , et al.   Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever, ehrlichioses, and anaplasmosis—United States: a practical guide for physicians and other health-care and public health professionals . MMWR Recomm. Rep. . 2006;55:1–27
  60. Dalton MJ , et al.   National surveillance for Rocky Mountain spotted fever, 1981–1992: epidemiologic summary and evaluation of risk factors for fatal outcome . Am. J. Trop. Med. Hyg. . 1995;52:405–413
  61. Thomas LD , et al.   Human ehrlichiosis in transplant recipients . Am. J. Transplant. . 2007;7:1641–1647
  62. Demma LJ , et al.   Epidemiology of human ehrlichiosis and anaplasmosis in the United States, 2001–2002 . Am. J. Trop. Med. Hyg. . 2005;73:400–409
  63. Ratnasamy N , et al.   Central nervous system manifestations of human ehrlichiosis . Clin. Infect. Dis. . 1996;23:314–319
  64. Harkess JR , Stucky D , Ewing SA . Neurologic abnormalities in a patient with human ehrlichiosis . South Med. J. . 1990;83:1341–1343
  65. Schutze GE , et al.   Human monocytic ehrlichiosis in children . Pediatr. Infect. Dis. J. . 2007;26:475–479
  66. Standaert SM , et al.   Primary isolation of Ehrlichia chaffeensis from patients with febrile illnesses: clinical and molecular characteristics . J. Infect. Dis. . 2000;181:1082–1088
  67. Olano JP , et al.   Human monocytotropic ehrlichiosis, Missouri . Emerg. Infect. Dis. . 2003;9:1579–1586

 Editor's Note: Part II of this article will appear in the February 15, 2010 issue of CMN (Volume 32, Number 4).

PII: S0196-4399(10)00002-4

doi: 10.1016/j.clinmicnews.2010.01.001

Clinical Microbiology Newsletter
Volume 32, Issue 3 , Pages 17-23 , 1 February 2010