Csf Viral Screen Pcr Csf

The introduction of molecular techniques, laboratory diagnosis of viral infections of the central nervous system (CNS) relied on virus isolation in cell culture, detection of specific antibody production in cerebrospinal fluid (CSF), or, for encephalitis caused by herpes simplex virus (HSV), viral antigen. Commonest causes of viral meningitis and encephalitis is herpes simplex virus HSV type 1 HSV-1, HSV type 2 HSV-2, varicella-zoster virus VZV, and enteroviruses was developed, and its sensitivity was compared with those of similar assays described previously for this application. Compared to the previous assays, this single multiplex PCR assay had higher molecular sensitivities for the detection for each of the viruses and improved utility for routine use in a diagnostic laboratory. Before the introduction of molecular techniques, laboratory diagnosis of viral infections of the central nervous system (CNS) relied on virus isolation in cell culture, detection of specific antibody production in cerebrospinal fluid (CSF), or, for encephalitis caused by herpes simplex virus (HSV), viral antigen detection in tissue from brain biopsy specimens. With the exception of the last procedure, which is highly invasive, the impact of laboratory diagnosis on acute patient management was relatively small because of the time taken for virus replication to produce a characteristic cytopathic effect in cell culture or for the development of a specific antibody response. The use of PCR for the diagnosis of CNS disease has been well evaluated for HSV encephalitis (4, 6, 7, 9) and enterovirus meningitis (12, 15, 17, 19). The use of this highly sensitive technique has increased our understanding of the etiological role of viruses in CNS disease. It has been demonstrated that varicella-zoster virus (VZV) and HSV type 2 (HSV-2) can cause meningitic symptoms without causing concurrent skin lesions.