Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil; Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil.
J Med Virol. 2014 Sep;86(9):1522-7. doi: 10.1002/jmv.23953. Epub 2014 Apr 24.
Acute infections of the central nervous system (CNS) can be caused by various pathogens. In this study, the presence of herpesviruses (HHV), enteroviruses (EVs), and arboviruses were investigated in CSF samples from 165 patients with suspected CNS viral infection through polymerase chain reaction (PCR) and reverse transcriptase PCR. The genomes of one or more viral agents were detected in 29.7% (49/165) of the CSF samples. EVs were predominant (16/49; 32.6%) followed by Epstein-Barr virus (EBV) (22.4%), Varicella-Zoster virus (VZV) (20.4%), Cytomegalovirus (CMV) (18.4%), herpes simplex virus (HSV-1) (4.1%), (HSV-2) (4.1%), and the arboviruses (14.3%). Four of the arboviruses were of dengue virus (DENV) and three of oropouche virus (OROV). The detection of different viruses in the CNS of patients with meningitis or encephalitis highlight the importance of maintaining an active laboratory monitoring diagnostics with rapid methodology of high sensitivity in areas of viral hyperendemicity that may assist in clinical decisions and in the choice of antiviral therapy.
急性中枢神经系统(CNS)感染可由各种病原体引起。在这项研究中,通过聚合酶链反应(PCR)和逆转录 PCR,对 165 例疑似 CNS 病毒感染患者的脑脊液样本进行了疱疹病毒(HHV)、肠道病毒(EV)和虫媒病毒的检测。在 29.7%(49/165)的脑脊液样本中检测到一种或多种病毒的基因组。肠道病毒(EV)最为常见(16/49;32.6%),其次是 EBV(22.4%)、VZV(20.4%)、CMV(18.4%)、HSV-1(4.1%)、HSV-2(4.1%)和虫媒病毒(14.3%)。其中 4 种虫媒病毒为登革热病毒(DENV),3 种为奥罗普切病毒(OROV)。在脑膜炎或脑炎患者的中枢神经系统中检测到不同的病毒,突出表明在病毒高度流行地区保持积极的实验室监测诊断非常重要,快速、高灵敏度的方法可能有助于临床决策和抗病毒治疗的选择。