Herpesvirus DNA detection in cerebral spinal fluid: Differences in clinical presentation between alpha-, beta-, and gamma-herpesviruses

To evaluate the role of 6 human herpesviruses (cytomegalovirus (CMV), Epste in-Barr virus (EBV), human herpesvirus-6 (HHV-6), herpes simplex virus (HSV ) types 1 and 2 and varicella tester virus (VZV)) in infections of the nerv ous system, cerebrospinal fluid (CSF) samples from 662 patients with suspec ted viral aetiology to neurological symptoms were investigated for presence of herpesviral DNA in a PCR-based study. Of the 69 patients (2 patients ha d 2 herpesvirus DNA detected in CSF) who had herpesvirus DNA detected in th e CSF, 60 (87%) were non-immunocompromised (CMV 7; HHV-6 6; EBV 16; HSV-1 1 8; HSV-2 9 and VZV 6) and 9 (13%) were immunocompromised (CMV 3; HHV-6 0; E BV 5; HSV-1 0; HSV-2 1 and VZV 0), The study was performed in a retrospecti ve/prospective manner. The HSV-1, HSV-2, VZV and CMV DNA-positive patients usually had typical clinical syndromes, such as encephalitis/myelitis and m eningitis, but also other neurological conditions were associated with find ings of these viruses. HHV-6 and EBV DNA were detected in patients presenti ng with a variety of neurological symptoms, and in some of the cases, concu rrent with diagnosis of other infections of the central nervous system, Des pite the overall variability of clinical conditions seen, a pattern associa ted with each investigated herpesvirus was discernable as regards clinical presentation.