Missing Cases of Herpes Simplex Virus (HSV) Infection of the Central Nervous System When the Reller Criteria Are Applied for HSV PCR Testing: a Multicenter Study
| Autor: | Adelina Gimeno, María Ángeles Clari, Nieves Orta, María Victoria Domínguez Márquez, María Gil-Fortuño, J. M. Nogueira, Juan Alberola, Isabel Valero, Eliseo Albert, J.J. Camarena, Juan Carlos Rodríguez, David Navarro, Monserrat Bosque, María Dolores Ocete, Concepción Gimeno Cardona, Josep Prat |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Microbiology (medical) Adolescent viruses Central nervous system HSL and HSV medicine.disease_cause Polymerase Chain Reaction law.invention Young Adult Cerebrospinal fluid law Virology White blood cell Humans Simplexvirus Medicine Diagnostic Errors Child Polymerase chain reaction Aged Cerebrospinal Fluid Retrospective Studies Aged 80 and over Hsv infection Diagnostic Tests Routine business.industry Infant Newborn Infant Middle Aged Herpes simplex virus medicine.anatomical_structure Multicenter study Child Preschool DNA Viral Immunology Female Encephalitis Herpes Simplex business |
| Zdroj: | Journal of Clinical Microbiology. 57 |
| ISSN: | 1098-660X 0095-1137 |
| Popis: | Previous studies suggested that herpes simplex virus (HSV) PCR testing can be safely deferred in patients with normal cerebrospinal fluid (CSF) white blood cell (WBC) counts and protein levels as long as they are older than 2 years of age and are not immunocompromised, the so-called Reller criteria. In this multicenter study, we retrospectively assessed the validity of these screening criteria in our setting. A total of 4,404 CSF specimens submitted for HSV PCR testing to the respective microbiology laboratories at the participating hospitals between 2012 and 2018 were included. Six commercially available HSV PCR assays were used across the participating centers. Ninety-one of the 4,404 CSF specimens (2.1%) tested were positive for HSV DNA (75 samples for HSV-1 and 16 for HSV-2). Nine patients failed to meet the Reller criteria, of whom seven were deemed to truly have HSV encephalitis. Overall, no significant correlation between HSV PCR cycle threshold (CT) values and WBC counts or total protein levels was found. In addition, median HSV PCR CTs were comparable between patients who met the Reller criteria and those who did not (P = 0.531). In summary, we show that HSV DNA may be detected in CSF specimens with normal WBC and protein levels collected from immunocompetent individuals older than 2 years with HSV encephalitis. Nevertheless, the data also indicate that the number of cases detected could be lowered at least by half if CSF specimens with borderline WBC counts (4 cells/mm3) as well as children of any age are systematically tested. |
| Databáze: | OpenAIRE |
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