The value of cerebrospinal fluid antiviral antibody in the diagnosis of neurologic disease produced by varicella zoster virus

Gilden, Donald H.; Bennett, Jeffrey L.; Kleinschmidt‐DeMasters, Bette K.; Song, Dong-Ho; Yee, Audrey S.; Steiner, Israel

doi:10.1016/s0022-510x(98)00153-1

Cited by 106 publications

(90 citation statements)

References 10 publications

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“…Direct infection of the CNS by VZV during chicken pox is fortunately rare but can produce meningoencephalitis. Pathological studies indicate that many cases of encephalitis are in fact due to either large-or small-vessel vasculopathy resulting from viral infection of vascular endothelium (94,129). More frequently CNS involvement occurs as a result of ADEM, a postinfectious, immune-mediated, predominantly demyelinating process.…”

Section: Viruses For Which Pcr Has Potential Efficacy In Diagnosis Bumentioning

confidence: 99%

“…CSF PCR is positive for VZV DNA in the majority of these cases, and intrathecal synthesis of VZV-specific antibody occurs. Other groups have documented lower sensitivity of CSF PCR in the setting of subacute to chronic CNS VZV infection (myelitis and encephalitis) and have stressed that intrathecal synthesis of VZV-specific antibody may be a more reliable diagnostic measure in such cases, particularly with intervals of weeks to months between zoster and onset of neurologic disease (94).…”

Section: Viruses For Which Pcr Has Potential Efficacy In Diagnosis Bumentioning

confidence: 99%

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Molecular Methods for Diagnosis of Viral Encephalitis

2004

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Hundreds of viruses cause central nervous system (CNS) disease, including meningoencephalitis and postinfectious encephalomyelitis, in humans. The cerebrospinal fluid (CSF) is abnormal in >90% of cases; however, routine CSF studies only rarely lead to identification of a specific etiologic agent. Diagnosis of viral infections of the CNS has been revolutionized by the advent of new molecular diagnostic technologies to amplify viral nucleic acid from CSF, including PCR, nucleic acid sequence-based amplification, and branched-DNA assay. PCR is ideally suited for identifying fastidious organisms that may be difficult or impossible to culture and has been widely applied for detection of both DNA and RNA viruses in CSF. The technique can be performed rapidly and inexpensively and has become an integral component of diagnostic medical practice in the United States and other developed countries. In addition to its use for identification of etiologic agents of CNS disease in the clinical setting, PCR has also been used to quantitate viral load and monitor duration and adequacy of antiviral drug therapy. PCR has also been applied in the research setting to help discriminate active versus postinfectious immune-mediate disease, identify determinants of drug resistance, and investigate the etiology of neurologic disease of uncertain cause. This review discusses general principles of PCR and reverse transcription-PCR, including qualitative, quantitative, and multiplex techniques, with comment on issues of sensitivity, specificity, and positive and negative predictive values. The application of molecular diagnostic methods for diagnosis of specific infectious entities is reviewed in detail, including viruses for which PCR is of proven efficacy and is widely available, viruses for which PCR is less widely available or for which PCR has unproven sensitivity and specificity, and nonviral entities which can mimic viral CNS disease

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Section: Viruses For Which Pcr Has Potential Efficacy In Diagnosis Bumentioning

confidence: 99%

Section: Viruses For Which Pcr Has Potential Efficacy In Diagnosis Bumentioning

confidence: 99%

Molecular Methods for Diagnosis of Viral Encephalitis

2004

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“…Typically, the immune response in the CSF is expected 10 to 12 days from the onset of the CNS disease. 26,27 (5) Subarachnoid and intraventricular hemorrhages are rare findings in VZV encephalitis. To our knowledge, only four cases of subarachnoid hemorrhage have been published, and no cases of intraventricular hemorrhage have been published.…”

Section: Discussionmentioning

confidence: 99%

Atypical presentation of varicella-zoster virus encephalitis in an immunocompetent adult

2008

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“…In these cases a high level of suspicion should be maintained and laboratory tests such as PCR for VZV or CSF anti-VZV antibodies should be ordered. We suspect that the DNA PCR was negative in the CSF of our patient as a result of the delay in CSF sampling [5,7]. The lumbar puncture was performed during the first days of hospitalization, two weeks after the patient first noted symptoms.…”

mentioning

confidence: 91%

“…Microbiological studies carried out in serum and CSF for virus, bacteria, mycobacteria and fungus were all negative with the exception of VZV. Although the amplification of VZV DNA from CSF by a polimerase chain reaction (PCR) was negative, an enzyme immunoassay (EIA) in CSF detected IgG antibodies to VZV at a level of 3.15 OD (normal < 1.0 OD), with the CSF/serum ratio of anti-VZV IgG elevated (antibody index > 4) compared with normal CSF/serum ratio for the total IgG, indicating intrathechal synthesis of anti-VZV antibodies [4,5].…”

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confidence: 99%