Jayakeerthi Rangaiah S, Potula Raghava V, Srinivasan S, Badrinath S
Department of Microbiology, Jawaharlal Institute of Post-graduate Medical Education and Research, Pondicherry-605 006, India.
Virol J. 2006 Jan 6;3:2. doi: 10.1186/1743-422X-3-2.
Encephalitis caused by flaviviruses, Japanese encephalitis virus (JEV) and West Nile virus (WNV) is responsible for significant morbidity and mortality in many endemic countries. Dengue-2 (Den-2) virus is a recent addition to the list of encephalitogenic viruses, after its Central Nervous System (CNS) invasion capability has been established. There is a wide array of laboratory tools that have helped us not only in the diagnosis of these conditions but also in understanding their pathogenesis and pathology. However, there are no reports of Shell Vial Culture (SVC), a centrifuge enhanced tissue culture assay that has revolutionized viral culturing in terms of rapidity and sensitivity being optimized for these flaviviral encephalitic conditions. The present study is an attempt to standardize and evaluate the usefulness of SVC for the laboratory diagnosis of JE, WN and Den-2 encephalitis cases and to compare it with Indirect Immunofluorescence (IIF) technique that detects cell associated virus antigen. Analysis of the various clinical parameters with respect to viral etiology has also been carried out.
Pediatric patients constituted the major group involved in the study (92%). Etiological diagnosis of viral encephalitis could be established in twenty nine (58%) patients. JE encephalitis was the commonest with 19 (39%) cases being positive followed by, WN (9 cases-18%) and Den-2 (one case). IIF test could detect antigens of JE, WN and Den-2 viruses in 16(32%), 7(14%) and 1 case respectively. Shell vial culture assay picked up all cases that were positive by IIF test. In addition, SVC assay could detect 3 and 2 more cases of JE and WN encephalitis respectively, that were negative by the IIF test.
Shell vial culture is a rapid and efficient tool for the etiological diagnosis of JE, WN and Den-2 encephalitis cases. Early, prompt collection, transport and processing of the CSF samples, would make SVC a better method for the rapid diagnosis of these flaviviral infections.
黄病毒引起的脑炎，如日本脑炎病毒（JEV）和西尼罗河病毒（WNV），在许多流行国家导致了显著的发病率和死亡率。登革2型（Den-2）病毒在其侵入中枢神经系统（CNS）的能力得到证实后，最近也被列入致脑炎病毒名单。有大量实验室工具不仅帮助我们诊断这些疾病，还帮助我们了解其发病机制和病理。然而，尚无关于空斑小室培养（SVC）的报道，这是一种经离心增强的组织培养检测方法，在快速性和敏感性方面对这些黄病毒脑炎情况进行了优化，从而彻底改变了病毒培养。本研究旨在标准化并评估SVC在实验室诊断JE、WN和Den-2脑炎病例中的实用性，并将其与检测细胞相关病毒抗原的间接免疫荧光（IIF）技术进行比较。还对与病毒病因相关的各种临床参数进行了分析。
儿科患者是本研究涉及的主要群体（92%）。29例（58%）患者可确诊为病毒性脑炎。JE脑炎最为常见，19例（39%）呈阳性，其次是WN（9例 - 18%）和Den-2（1例）。IIF检测分别在16例（32%）、7例（14%）和1例中检测到JE、WN和Den-2病毒抗原。空斑小室培养检测出了所有IIF检测呈阳性的病例。此外，SVC检测分别还能检测出3例和2例IIF检测为阴性的JE和WN脑炎病例。
空斑小室培养是诊断JE、WN和Den-2脑炎病例病因的快速有效工具。脑脊液样本的早期、及时采集、运输和处理，将使SVC成为快速诊断这些黄病毒感染的更好方法。
