Kimberlin D W, Lakeman F D, Arvin A M, Prober C G, Corey L, Powell D A, Burchett S K, Jacobs R F, Starr S E, Whitley R J
Department of Pediatrics, University of Alabama at Birmingham, 35233, USA.
J Infect Dis. 1996 Dec;174(6):1162-7. doi: 10.1093/infdis/174.6.1162.
Cerebrospinal fluid (CSF) specimens from 77 neonates with herpes simplex virus (HSV) disease were evaluated retrospectively by polymerase chain reaction (PCR). Samples were collected from 202 infants enrolled in a National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group trial that compared vidarabine with acyclovir for the treatment of neonatal HSV infection. HSV DNA was detected in the CSF of 26 (76%) of 34 infants with CNS disease, in 13 (93%) of 14 infants with disseminated infection, and in 7 (24%) of 29 with skin, eye, or mouth (SEM) involvement. One of the 7 PCR-positive SEM patients subsequently developed severe neurologic impairment. Eighteen (95%) of 19 infants with positive CSF PCR results after the completion of 10 days of antiviral therapy experienced significant morbidity or mortality. Application of PCR to neonatal HSV disease may provide additional information on which clinical decisions may be based, although its diagnostic utility outside the research setting is unproven.
对77例患有单纯疱疹病毒（HSV）疾病的新生儿的脑脊液（CSF）样本进行了回顾性聚合酶链反应（PCR）评估。样本取自参与美国国立过敏与传染病研究所合作抗病毒研究组试验的202例婴儿，该试验比较了阿糖腺苷与阿昔洛韦治疗新生儿HSV感染的效果。在34例患有中枢神经系统疾病的婴儿中，26例（76%）的脑脊液中检测到HSV DNA；在14例患有播散性感染的婴儿中，13例（93%）检测到；在29例有皮肤、眼或口（SEM）受累的婴儿中，7例（24%）检测到。7例PCR检测呈阳性的SEM患者中有1例随后出现严重神经功能损害。19例在抗病毒治疗10天后脑脊液PCR结果呈阳性的婴儿中，18例（95%）出现了严重发病或死亡。将PCR应用于新生儿HSV疾病可能会提供一些可作为临床决策依据的额外信息，尽管其在研究环境之外的诊断效用尚未得到证实。
