LABORATORY DIAGNOSIS OF CENTRAL-NERVOUS-SYSTEM INFECTIONS WITH HERPES-SIMPLEX VIRUS BY PCR PERFORMED WITH CEREBROSPINAL-FLUID SPECIMENS

Until recently, the laboratory diagnosis of central nervous system (CN S) infections with herpes simplex virus (HSV) has been limited by poor sensitivity and/or specificity, We assessed the diagnostic utility of PCR for detection of HSV in over 2,100 specimens referred to the Mayo Clinic from August 1993 to May 1996, DNA extracted from cerebrospinal fluid (CSF) samples with IsoQuick was amplified by PCR with oligonucl eotide primers directed to the DNA polymerase gene of HSV, yielding a 290-bp amplicon, HSV DNA was detected in 150 (135 by gel electrophores is, 15 by Southern blotting only) 2,106 (7.1%) specimens, PCR-positive CNS disease occurred in patients ranging in age from 13 days to 89 ye ars; 59% of the cases occurred in patients between the ages of 30 and 69, and 21 (14%) of the patients were infants, Genotype analysis was n ot routinely performed; however, amplification of a 335-bp product wit hin the thymidine kinase gene of HSV revealed 13 positions within a sp an of 80 nucleotides that accurately identified the two serotypes of t he virus according to 14 reference strains, We conclude that PCR detec tion of HSV DNA in CSF specimens should be considered an emerging ''go ld standard'' for the laboratory diagnosis of CNS infections with this virus.