Skip to main content
NCBI home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1997 Mar;35(3):691–696. doi: 10.1128/jcm.35.3.691-696.1997

Aseptic meningitis and encephalitis: the role of PCR in the diagnostic laboratory.

S J Read 1, K J Jeffery 1, C R Bangham 1
PMCID: PMC229652  PMID: 9041414

Abstract

In this study we have devised a simple and robust PCR strategy to detect a wide range of viruses, bacteria, and parasites, all of which are capable of causing aseptic meningitis and encephalitis. The techniques developed have been used in a routine diagnostic virology laboratory to test prospectively 2,233 cerebrospinal fluid specimens. A virus was detected in 147 specimens of cerebrospinal fluid from 143 patients. Four sets of primers were sufficient to detect the virus in 135 (94%) of the PCR-positive patients. We conclude that with appropriate primers, PCR can be systematically and economically applied to test for a range of organisms in a routine diagnostic laboratory. In our opinion, PCR will soon become the "gold standard" test for viral infections of the central nervous system.

Full Text

The Full Text of this article is available as a PDF (125.5 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allard A., Albinsson B., Wadell G. Detection of adenoviruses in stools from healthy persons and patients with diarrhea by two-step polymerase chain reaction. J Med Virol. 1992 Jun;37(2):149–157. doi: 10.1002/jmv.1890370214. [DOI] [PubMed] [Google Scholar]
  2. Boom R., Sol C. J., Salimans M. M., Jansen C. L., Wertheim-van Dillen P. M., van der Noordaa J. Rapid and simple method for purification of nucleic acids. J Clin Microbiol. 1990 Mar;28(3):495–503. doi: 10.1128/jcm.28.3.495-503.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Chonmaitree T., Baldwin C. D., Lucia H. L. Role of the virology laboratory in diagnosis and management of patients with central nervous system disease. Clin Microbiol Rev. 1989 Jan;2(1):1–14. doi: 10.1128/cmr.2.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cinque P., Brytting M., Vago L., Castagna A., Parravicini C., Zanchetta N., D'Arminio Monforte A., Wahren B., Lazzarin A., Linde A. Epstein-Barr virus DNA in cerebrospinal fluid from patients with AIDS-related primary lymphoma of the central nervous system. Lancet. 1993 Aug 14;342(8868):398–401. doi: 10.1016/0140-6736(93)92814-a. [DOI] [PubMed] [Google Scholar]
  5. Corey L., Adams H. G., Brown Z. A., Holmes K. K. Genital herpes simplex virus infections: clinical manifestations, course, and complications. Ann Intern Med. 1983 Jun;98(6):958–972. doi: 10.7326/0003-4819-98-6-958. [DOI] [PubMed] [Google Scholar]
  6. Dennett C., Klapper P. E., Cleator G. M., Lewis A. G. CSF pretreatment and the diagnosis of herpes encephalitis using the polymerase chain reaction. J Virol Methods. 1991 Sep;34(1):101–104. doi: 10.1016/0166-0934(91)90125-j. [DOI] [PubMed] [Google Scholar]
  7. Esolen L. M., Ward B. J., Moench T. R., Griffin D. E. Infection of monocytes during measles. J Infect Dis. 1993 Jul;168(1):47–52. doi: 10.1093/infdis/168.1.47. [DOI] [PubMed] [Google Scholar]
  8. Gibson P. E., Knowles W. A., Hand J. F., Brown D. W. Detection of JC virus DNA in the cerebrospinal fluid of patients with progressive multifocal leukoencephalopathy. J Med Virol. 1993 Apr;39(4):278–281. doi: 10.1002/jmv.1890390404. [DOI] [PubMed] [Google Scholar]
  9. Hammer S. M., Connolly K. J. Viral aseptic meningitis in the United States: clinical features, viral etiologies, and differential diagnosis. Curr Clin Top Infect Dis. 1992;12:1–25. [PubMed] [Google Scholar]
  10. Jaton K., Sahli R., Bille J. Development of polymerase chain reaction assays for detection of Listeria monocytogenes in clinical cerebrospinal fluid samples. J Clin Microbiol. 1992 Aug;30(8):1931–1936. doi: 10.1128/jcm.30.8.1931-1936.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Lakeman F. D., Whitley R. J. Diagnosis of herpes simplex encephalitis: application of polymerase chain reaction to cerebrospinal fluid from brain-biopsied patients and correlation with disease. National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. J Infect Dis. 1995 Apr;171(4):857–863. doi: 10.1093/infdis/171.4.857. [DOI] [PubMed] [Google Scholar]
  12. MEYER H. M., Jr, JOHNSON R. T., CRAWFORD I. P., DASCOMB H. E., ROGERS N. G. Central nervous system syndromes of "vital" etiology. A study of 713 cases. Am J Med. 1960 Aug;29:334–347. doi: 10.1016/0002-9343(60)90029-2. [DOI] [PubMed] [Google Scholar]
  13. Ostergaard L., Nielsen A. K., Black F. T. DNA amplification on cerebrospinal fluid for diagnosis of cerebral toxoplasmosis among HIV-positive patients with signs or symptoms of neurological disease. Scand J Infect Dis. 1993;25(2):227–237. doi: 10.3109/00365549309008489. [DOI] [PubMed] [Google Scholar]
  14. Perosio P. M., Frank T. S. Detection and species identification of mycobacteria in paraffin sections of lung biopsy specimens by the polymerase chain reaction. Am J Clin Pathol. 1993 Dec;100(6):643–647. doi: 10.1093/ajcp/100.6.643. [DOI] [PubMed] [Google Scholar]
  15. Powell K. F., Anderson N. E., Frith R. W., Croxson M. C. Non-invasive diagnosis of herpes simplex encephalitis. Lancet. 1990 Feb 10;335(8685):357–358. doi: 10.1016/0140-6736(90)90648-o. [DOI] [PubMed] [Google Scholar]
  16. Savio M. L., Rossi C., Fusi P., Tagliabue S., Pacciarini M. L. Detection and identification of Leptospira interrogans serovars by PCR coupled with restriction endonuclease analysis of amplified DNA. J Clin Microbiol. 1994 Apr;32(4):935–941. doi: 10.1128/jcm.32.4.935-941.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Sawyer M. H., Holland D., Aintablian N., Connor J. D., Keyser E. F., Waecker N. J., Jr Diagnosis of enteroviral central nervous system infection by polymerase chain reaction during a large community outbreak. Pediatr Infect Dis J. 1994 Mar;13(3):177–182. doi: 10.1097/00006454-199403000-00002. [DOI] [PubMed] [Google Scholar]
  18. Schlesinger Y., Tebas P., Gaudreault-Keener M., Buller R. S., Storch G. A. Herpes simplex virus type 2 meningitis in the absence of genital lesions: improved recognition with use of the polymerase chain reaction. Clin Infect Dis. 1995 Apr;20(4):842–848. doi: 10.1093/clinids/20.4.842. [DOI] [PubMed] [Google Scholar]
  19. Stanway G., Kalkkinen N., Roivainen M., Ghazi F., Khan M., Smyth M., Meurman O., Hyypiä T. Molecular and biological characteristics of echovirus 22, a representative of a new picornavirus group. J Virol. 1994 Dec;68(12):8232–8238. doi: 10.1128/jvi.68.12.8232-8238.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Thorén A., Widell A. PCR for the diagnosis of enteroviral meningitis. Scand J Infect Dis. 1994;26(3):249–254. doi: 10.3109/00365549409011792. [DOI] [PubMed] [Google Scholar]
  21. Wakefield A. J., Fox J. D., Sawyerr A. M., Taylor J. E., Sweenie C. H., Smith M., Emery V. C., Hudson M., Tedder R. S., Pounder R. E. Detection of herpesvirus DNA in the large intestine of patients with ulcerative colitis and Crohn's disease using the nested polymerase chain reaction. J Med Virol. 1992 Nov;38(3):183–190. doi: 10.1002/jmv.1890380306. [DOI] [PubMed] [Google Scholar]
  22. Wilborn F., Brinkmann V., Schmidt C. A., Neipel F., Gelderblom H., Siegert W. Herpesvirus type 6 in patients undergoing bone marrow transplantation: serologic features and detection by polymerase chain reaction. Blood. 1994 May 15;83(10):3052–3058. [PubMed] [Google Scholar]
  23. de Barbeyrac B., Bernet-Poggi C., Fébrer F., Renaudin H., Dupon M., Bébéar C. Detection of Mycoplasma pneumoniae and Mycoplasma genitalium in clinical samples by polymerase chain reaction. Clin Infect Dis. 1993 Aug;17 (Suppl 1):S83–S89. doi: 10.1093/clinids/17.supplement_1.s83. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES