Akya Alisha, Ahmadi Kamal, Zehtabian Shahram, Salimi Afsaneh, Elahi Azam, Madani Sayed Hamid
Nosocomial Infection Research Centre, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IR Iran.
MSc Student of Medical Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IR Iran.
Jundishapur J Microbiol. 2015 Oct 18;8(10):e22639. doi: 10.5812/jjm.22639. eCollection 2015 Oct.
Aseptic meningitis is the most common type of meningitis and is characterized by meningeal inflammation that is not linked to identifiable bacterial pathogens in cerebrospinal fluid (CSF).
This study aimed to evaluate the frequency of aseptic meningitis caused by herpesviruses, namely herpes simplex types I and II (HSV-1, HSV-2), Epstein-Barr virus (EBV), cytomegalovirus (CMV) and varicella-zoster virus (VZV).
A total of 196 CSF samples were collected from patients with suspected meningitis. All samples were smear- and culture-negative for bacterial pathogens. The biochemical and cytological findings of CSF samples were also recorded. DNA was extracted from samples and PCR with specific primers was carried out to detect viruses.
The 196 samples derived from 100 (52%) men and 96 (48%) women ranging in age from one day to 86 years with an average age of 32.3 ± 25.3 years. Of them, 8 (4.08%) samples yielded positive results, including 5 (2.55%) cases of VZV infection and 3 (1.53%) cases of HSV-1 infection. No cases of HSV-2, CMV or EBV infection were detected. CSF protein and glucose levels among positive cases were all in the normal range.
The results indicate a considerable rate of herpesvirus infection in patients with aseptic meningitis, and that VZV is the most common herpesvirus to cause infection followed by HSV-1. Our results also showed that a moderate increase in the WBC count and predominance of lymphocytes can be valuable clues in diagnosing viral meningitis. Given the different approaches of drug therapy in bacterial and viral meningitis, use of molecular methods is necessary in hospitals to rapidly discriminate between them.
无菌性脑膜炎是最常见的脑膜炎类型，其特征是脑膜炎症，且脑脊液（CSF）中未发现可识别的细菌病原体。
本研究旨在评估由疱疹病毒引起的无菌性脑膜炎的发生率，这些疱疹病毒包括单纯疱疹病毒I型和II型（HSV-1、HSV-2）、爱泼斯坦-巴尔病毒（EBV）、巨细胞病毒（CMV）和水痘-带状疱疹病毒（VZV）。
共收集了196份疑似脑膜炎患者的脑脊液样本。所有样本的细菌病原体涂片和培养均为阴性。还记录了脑脊液样本的生化和细胞学检查结果。从样本中提取DNA，并使用特异性引物进行PCR以检测病毒。
196份样本来自100名（52%）男性和96名（48%）女性，年龄从1天到86岁不等，平均年龄为32.3±25.3岁。其中，8份（4.08%）样本检测结果为阳性，包括5份（2.55%）VZV感染病例和3份（1.53%）HSV-1感染病例。未检测到HSV-2、CMV或EBV感染病例。阳性病例的脑脊液蛋白质和葡萄糖水平均在正常范围内。
结果表明无菌性脑膜炎患者中疱疹病毒感染率相当高，且VZV是最常见的引起感染的疱疹病毒，其次是HSV-1。我们的结果还表明，白细胞计数适度增加和淋巴细胞占优势可能是诊断病毒性脑膜炎的重要线索。鉴于细菌性和病毒性脑膜炎的药物治疗方法不同，医院有必要使用分子方法快速区分它们。
