O'Sullivan Cathal E, Aksamit Allen J, Harrington Jeffrey R, Harmsen W Scott, Mitchell P Shawn, Patel Robin
Division of Clinical Microbiology, Mayo Clinic, Rochester, Minn 55905, USA.
Mayo Clin Proc. 2003 Nov;78(11):1347-52. doi: 10.4065/78.11.1347.
To determine the clinical, neurologic, and laboratory characteristics of patients with herpes simplex virus (HSV) type 1 (HSV-1) or HSV type 2 (HSV-2) DNA detected in cerebrospinal fluid (CSF) with use of polymerase chain reaction.
Clinical, laboratory, and demographic data were determined from 249 CSF specimens (collected from 247 patients >10 years of age) that tested positive for HSV-1 or HSV-2 DNA at the Mayo Clinic from January 1999 to August 2000.
The median age of the 200 patients whose age was available was 70 years vs 40 years for those with HSV-1 or HSV-2 DNA in CSF, respectively. Detailed data were available for 39 and 78 patients with positive polymerase chain reaction results for HSV-1 and HSV-2, respectively. Of those with HSV-1 DNA detected in CSF, 89% had encephalitis, whereas most patients with HSV-2 DNA detected in CSF had findings compatible with meningitis. Only 5 (7%) of 69 patients in whom HSV-2 was detected in CSF had genital lesions at presentation, and none of the assessable patients with HSV-2 who had recurrent meningitis had active genital lesions at presentation.
The vast majority (82%) of patients with HSV-2 detected in CSF had no history of genital herpes and no lesions at the time of presentation. Polymerase chain reaction assays designed to detect HSV in CSF should detect HSV-1 and HSV-2 and differentiate between HSV-1 and HSV-2.
通过聚合酶链反应确定脑脊液（CSF）中检测到1型单纯疱疹病毒（HSV-1）或2型单纯疱疹病毒（HSV-2）DNA的患者的临床、神经学和实验室特征。
从1999年1月至2000年8月在梅奥诊所检测HSV-1或HSV-2 DNA呈阳性的249份脑脊液标本（从247例年龄大于10岁的患者中采集）中确定临床、实验室和人口统计学数据。
有年龄数据的200例患者的中位年龄为70岁，而脑脊液中检测到HSV-1或HSV-2 DNA的患者的中位年龄分别为40岁。分别有39例和78例聚合酶链反应结果为HSV-1和HSV-2阳性的患者有详细数据。脑脊液中检测到HSV-1 DNA的患者中，89%患有脑炎，而脑脊液中检测到HSV-2 DNA的大多数患者的表现符合脑膜炎。脑脊液中检测到HSV-2的69例患者中，只有5例（7%）在就诊时有生殖器病变，且所有可评估的复发性脑膜炎的HSV-2患者在就诊时均无活动性生殖器病变。
脑脊液中检测到HSV-2的绝大多数患者（82%）无生殖器疱疹病史，就诊时无病变。设计用于检测脑脊液中HSV的聚合酶链反应检测应能检测HSV-1和HSV-2，并区分HSV-1和HSV-2。
