Glimåker M, Lindquist L
Infektionskliniken, Karolinska sjukhuset, Stockholm.
Lakartidningen. 1999 Aug 25;96(34):3516-9.
While the enterovirus diagnostic test positive rate is very low in Sweden, many enterovirus diagnoses are probably missed, owing to inappropriate testing, in patients with acute aseptic meningitis. In the article it is recommended that the cerebrospinal fluid PCR (polymerase chain reaction) test should be performed routinely in cases of acute aseptic meningitis. Serology and virus isolation in stool are indicated in cases of acute pericarditis or myocarditis, or certain chronic heart diseases. The PCR test should be performed in serum in the few cases of sepsis-like diseases in newborns or patients with hypogammaglobulinaemia. Otherwise, enterovirus diagnosis is very seldom justified on clinical grounds. For the purpose of poliovirus surveillance, enterovirus isolation may be important for virus typing, especially in cases of paralytic conditions.
虽然在瑞典肠道病毒诊断检测的阳性率很低,但由于检测方法不当,急性无菌性脑膜炎患者中可能有许多肠道病毒感染未被诊断出来。文章建议,对于急性无菌性脑膜炎病例应常规进行脑脊液聚合酶链反应(PCR)检测。对于急性心包炎或心肌炎,或某些慢性心脏病病例,应进行粪便血清学检测和病毒分离。对于新生儿败血症样疾病或低丙种球蛋白血症患者的少数病例,应进行血清PCR检测。否则,很少能根据临床症状确诊肠道病毒感染。为了进行脊髓灰质炎病毒监测,肠道病毒分离对于病毒分型可能很重要,尤其是在出现麻痹症状的病例中。