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Erschienen in: Indian Journal of Pediatrics 4/2019

04.01.2019 | Scientific Letter

Suspected Herpes Simplex Encephalitis with Low Copy Number DNA

verfasst von: Koko Kato, Masahiro Kimura, Shinichiro Morichi, Gaku Yamanaka, Yasuyo Kashiwagi, Hisashi Kawashima

Erschienen in: Indian Journal of Pediatrics | Ausgabe 4/2019

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Excerpt

To the Editor: Real-time Polymerase chain reaction (PCR) and nested PCR have been used for the diagnosis of herpes simplex encephalitis (HSE) because of their sensitivity and rapidity [1]. However, low copy numbers of herpes simplex virus (HSV) may be overlooked, because a sample with less than 100 copies of HSV is judged as negative by the assays of many laboratory companies [2]. In this study, we assayed HSV-DNA using real-time PCR in cerebrospinal fluid (CSF) obtained from patients with suspected infection of the central nervous system (CNS). We performed HSV-DNA quantification by real-time PCR using the LightCycler® system. If there is a machine, measurement is possible within several hours with less than 2000 yen per sample. Five samples were positive for HSV. Their copy numbers were less than 100 and the same samples showed negative results for HSV-PCR when analyzed by a commercial laboratory. All patients of these 5 samples were clinically diagnosed as having severe infections; pneumococcal meningitis, complex febrile seizure, influenza encephalopathy, aseptic meningitis and upper tract infection. Three patients had status epilepticus. Loss of consciousness was seen in 2 patients. Abnormal head MRI findings were displayed in 2 patients, and abnormal non-periodic lateralized epileptiform discharges were seen in the electroencephalogram of 1 patient. Although HSV infection of the CNS might be associated with clinical status, this could not be concluded, because all positive patients had complications of serious CNS infections except HSE. Reactivation of HSV might result in low copy number HSE because all 5 patients had complications from severe infectious diseases. …
Literatur
1.
Zurück zum Zitat Burrows J, Nitsche A, Bayly B, et al. Detection and subtyping of herpes simplex virus in clinical samples by LightCycler PCR. enzyme immunoassay and cell culture BMC Microbiol. 2002;2:12.PubMed Burrows J, Nitsche A, Bayly B, et al. Detection and subtyping of herpes simplex virus in clinical samples by LightCycler PCR. enzyme immunoassay and cell culture BMC Microbiol. 2002;2:12.PubMed
2.
Zurück zum Zitat Domingues RB, Lakeman FD, Mayo MS, et al. Application of competitive PCR to cerebrospinal fluid samples from patients with herpes simplex encephalitis. J Clin Microbiol. 1998;36:2229–34.PubMedPubMedCentral Domingues RB, Lakeman FD, Mayo MS, et al. Application of competitive PCR to cerebrospinal fluid samples from patients with herpes simplex encephalitis. J Clin Microbiol. 1998;36:2229–34.PubMedPubMedCentral
Metadaten
Titel
Suspected Herpes Simplex Encephalitis with Low Copy Number DNA
verfasst von
Koko Kato
Masahiro Kimura
Shinichiro Morichi
Gaku Yamanaka
Yasuyo Kashiwagi
Hisashi Kawashima
Publikationsdatum
04.01.2019
Verlag
Springer India
Erschienen in
Indian Journal of Pediatrics / Ausgabe 4/2019
Print ISSN: 0019-5456
Elektronische ISSN: 0973-7693
DOI
https://doi.org/10.1007/s12098-018-2837-3

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