Rapid diagnosis of herpes simplex encephalitis by nested polymerase chain reaction assay of cerebrospinal fluid

doi:10.1016/0140-6736(91)92155-U

The Lancet

Volume 337, Issue 8735, 26 January 1991, Pages 189-192

https://doi.org/10.1016/0140-6736(91)92155-U Get rights and content

Abstract

With the aim of improving early diagnosis of herpes simplex encephalitis a polymerase chain reaction (PCR) assay with two "nested" primer pairs was developed for the amplification of herpes simplex virus DNA in cerebrospinal fluid (CSF). Southern blotting was used to confirm the specificity of the amplification. The assay was applied to 151 CSF samples from 43 consecutive patients with herpes simplex encephalitis verified by the finding of herpes simplex virus/viral antigen in a brain biopsy sample or at necropsy (13) and/or intrathecal production of IgG antibody to the virus (40). As controls, 87 CSF samples from 60 patients with acute febrile focal encephalopathy (initially suspected to be herpes simplex encephalitis but excluded by the absence of intrathecal antibody synthesis) were tested. PCR detected herpes simplex virus DNA in 42 of the 43 patients with proven herpes simplex encephalitis; all but 1 were positive in the first CSF sample taken. The 1 PCR-negative patient had been treated with acyclovir from 20 h after the onset of symptoms. All the control subjects were PCR negative, as were 270 internal contamination controls. The PCR result remained positive in samples drawn up to 27 days after the onset of neurological symptoms. This method is a rapid and non-invasive means to diagnose herpes simplex encephalitis; it is highly sensitive and specific.

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ORIGINAL ARTICLESRapid diagnosis of herpes simplex encephalitis by nested polymerase chain reaction assay of cerebrospinal fluid

Abstract

Lancet

Serodiagn Immunother Infect Dis

Serodiagn Immunother Infec Dis

Meth Enzymol

Lancet

Lancet

Lancet

Adenosinearabinoside therapy of biopsy-proved herpes simplex encephalitis

N Engl J Med

Herpes simplex virus infections of the nervous system

Arch Neurol

Brain and meningeal biopsy in the management of non-suppurative inflammatory intracranial disease

Aust NZ J Med

ORIGINAL ARTICLES
Rapid diagnosis of herpes simplex encephalitis by nested polymerase chain reaction assay of cerebrospinal fluid