Brain Infections Group, Walton Centre NHS Foundation Trust, and Institute of Infection and Global Health, University of Liverpool, The Apex Building, 8 West Derby Street, Liverpool, L69 7BE, UK.
Infection. 2013 Feb;41(1):27-31. doi: 10.1007/s15010-012-0292-z. Epub 2012 Jul 14.
We looked for herpes simplex virus types 1 and 2 (HSV-1 and HSV-2, respectively), varicella zoster virus (VZV), Epstein-Barr virus (EBV) and cytomegalovirus (CMV) DNA in Malawian adults with clinically suspected meningitis.
We collected cerebrospinal fluid (CSF) from consecutive adults admitted with clinically suspected meningitis to Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi, for a period of 3 months. Those with proven bacterial or fungal meningitis were excluded. Real-time polymerase chain reaction (PCR) was performed on the CSF for HSV-1 and HSV-2, VZV, EBV and CMV DNA.
A total of 183 patients presented with clinically suspected meningitis. Of these, 59 (32 %) had proven meningitis (bacterial, tuberculous or cryptococcal), 39 (21 %) had normal CSF and 14 (8 %) had aseptic meningitis. For the latter group, a herpes virus was detected in 9 (64 %): 7 (50 %) had EBV and 2 (14 %) had CMV, all were human immunodeficiency virus (HIV)-positive. HSV-2 and VZV were not detected. Amongst those with a normal CSF, 8 (21 %) had a detectable herpes virus, of which 7 (88 %) were HIV-positive.
The spectrum of causes of herpes viral meningitis in this African population is different to that in Western industrialised settings, with EBV being frequently detected in the CSF. The significance of this needs further investigation.
我们在马拉维的成年人中寻找临床疑似脑膜炎患者的单纯疱疹病毒 1 型和 2 型（HSV-1 和 HSV-2）、水痘带状疱疹病毒（VZV）、EB 病毒（EBV）和巨细胞病毒（CMV）DNA。
我们收集了马拉维伊丽莎白女王中央医院（QECH）连续住院的疑似脑膜炎的成年人的脑脊液（CSF），为期 3 个月。排除了经证实的细菌性或真菌性脑膜炎患者。我们对 CSF 中的 HSV-1 和 HSV-2、VZV、EBV 和 CMV DNA 进行了实时聚合酶链反应（PCR）。
共有 183 例患者出现临床疑似脑膜炎。其中，59 例（32%）患有细菌性、结核性或隐球菌性脑膜炎，39 例（21%）CSF 正常，14 例（8%）无菌性脑膜炎。对于后者，有 9 例（64%）发现疱疹病毒：7 例（50%）为 EBV，2 例（14%）为 CMV，均为 HIV 阳性。未检测到 HSV-2 和 VZV。在 CSF 正常的患者中，有 8 例（21%）可检测到疱疹病毒，其中 7 例（88%）为 HIV 阳性。
在非洲人群中，疱疹病毒脑膜炎的病因谱与西方工业化国家不同，CSF 中经常检测到 EBV。这一发现的意义需要进一步研究。
