Malm G, Forsgren M
Department of Paediatrics B68 Huddinge University Hospital Karolinska Institute 14186 Huddinge SE-1 Sweden.
Arch Dis Child Fetal Neonatal Ed. 1999 Jul;81(1):F24-9. doi: 10.1136/fn.81.1.f24.
To investigate the diagnostic potential of herpes simplex virus (HSV) DNA in cerebrospinal fluid and serum; to correlate the findings with outcome in the child and with type of maternal infection.
Cerebrospinal fluid and serum specimens from 36 children with verified neonatal HSV infections, diagnosed between 1973 and 1996, were examined using the polymerase chain reaction technique (PCR).
In 21 children for whom both cerebrospinal fluid and sera were available, HSV DNA was found in one or both specimens in 19 (90%). Overall, HSV DNA was found in the cerebrospinal fluid of 74% of 27 children, and in the sera of 20 out of 30 children (67%). In two children HSV DNA was not demonstrable in either serum or cerebrospinal fluid. In sequential specimens from four children, the persistence of HSV DNA after the end of intravenous treatment was associated with a poor prognosis.
These findings indicate that HSV DNA detection in CSF and serum is highly sensitive for the diagnosis of neonatal HSV infections but does not replace the detection of virus in other locations using virus isolation and antigen detection.
研究脑脊液和血清中单纯疱疹病毒(HSV)DNA的诊断潜力;将研究结果与患儿的预后以及母亲感染类型相关联。
采用聚合酶链反应技术(PCR)检测了1973年至1996年间确诊的36例新生儿HSV感染患儿的脑脊液和血清标本。
在可同时获得脑脊液和血清的21例患儿中,19例(90%)的一个或两个标本中发现了HSV DNA。总体而言,27例患儿中有74%的脑脊液中发现了HSV DNA,30例患儿中有20例(67%)的血清中发现了HSV DNA。有2例患儿的血清和脑脊液中均未检测到HSV DNA。在4例患儿的连续标本中,静脉治疗结束后HSV DNA的持续存在与预后不良相关。
这些结果表明,脑脊液和血清中HSV DNA检测对新生儿HSV感染的诊断具有高度敏感性,但不能替代使用病毒分离和抗原检测在其他部位检测病毒。