Viral diagnosis of neurological infection by RT multiplex PCR: A search for entero- and herpesviruses in a prospective study

The diagnosis of a wide range of different neurological syndromes was estab lished by a reverse transcription multiplex PCR assay. the presence of ente rovirus and herpesviruses was studied in cerebrospinal fluid samples collec ted prospectively from 200 patients hospitalized with neurological diseases suspected of viral infection. Positive PCR results for enterovirus and neu rotropic herpesvirus (herpes simplex, HSV, and varicella tester, VZV) were obtained among the immunocompetent patients (55/156, 35%) who presented ase ptic meningitis or encephalitis. Among immunocompromised patients the yield of positive PCR results was 41% (18/44), predominantly lymphotropic herpes viruses (15/44, 34%). Cytomegalovirus (CMV) DNA was detected in patients wi th several clinical syndromes, including encephalitis, chronic meningitis, retinitis, ventriculitis, polyradiculomyelitis, and myeloradiculitis. Epste in-Barr (EBV) and VZV-specific DNA sequences were detected in patients with either encephalitis, aseptic meningitis, and chronic meningitis. Dual infe ctions of CMV and HSV or CMV and EBV were established in two AIDS patients with encephalitis and polyradiculomyelitis, respectively. The applications of this RT multiplex PCR assay are extensive and may prove to be particular ly valuable for the rapid and sensitive diagnosis of neurological diseases in both immunocompetent and immunocompromised patients. (C) 1999 Wiley-Liss , Inc.