Validity of a PCR assay in CSF for the diagnosis of neurocysticercosis

Abstract

Objective:To prospectively evaluate the validity of a PCR assay in CSF for the diagnosis of neurocysticercosis (NC).Methods:We conducted a multicenter, prospective case-control study, recruiting participants from 5 hospitals in Cuenca, Ecuador, from January 2015 to February 2016. Cases fulfilled validated diagnostic criteria for NC. For each case, a neurosurgical patient who did not fulfill the diagnostic criteria for NC was selected as a control. CT and MRI, as well as a CSF sample, were collected from both cases and controls. The diagnostic criteria to identify cases were used as a reference standard.Results:Overall, 36 case and 36 control participants were enrolled. PCR had a sensitivity of 72.2% (95% confidence interval [CI] 54.8%–85.8%) and a specificity of 100.0% (95% CI 90.3%–100.0%). For parenchymal NC, PCR had a sensitivity of 42.9% (95% CI 17.7%–71.1%), and for extraparenchymal NC, PCR had a sensitivity of 90.9% (95% CI 70.8%–98.9%).Conclusions:This study demonstrated the usefulness of this PCR assay in CSF for the diagnosis of NC. PCR may be particularly helpful for diagnosing extraparenchymal NC when neuroimaging techniques have failed.Classification of evidence:This study provides Class III evidence that CSF PCR can accurately identify patients with extraparenchymal NC.

Next-Generation Sequencing of Cerebrospinal Fluid for the Diagnosis of Neurocysticercosis

“…The use of DNA-based techniques for NCC diagnosis has been reported ( 4 , 10 , 11 ). A recent polymerase chain reaction (PCR) assay study showed excellent sensitivity and specificity in the diagnosis of extraparenchymal NCC ( 11 ).…”

“…The use of DNA-based techniques for NCC diagnosis has been reported ( 4 , 10 , 11 ). A recent polymerase chain reaction (PCR) assay study showed excellent sensitivity and specificity in the diagnosis of extraparenchymal NCC ( 11 ). Next-generation sequencing (NGS) of CSF is being used increasingly for the clinical diagnosis of CNS infections ( 12 – 14 ).…”

Next generation sequencing based pathogen analysis in a patient with neurocysticercosis: a case report

“…Despite the availability of modern neuroimaging methods and reliable immunodiagnostic tests, diagnosis of NCC remains challenging, mainly due to variability in sensitivity and specificity of immunodiagnostic tests and a lack of typical neuroimaging findings in the majority of NCC cases. Detection of T. solium DNA in CSF by conventional PCR has been reported to have high sensitivity and specificity in Latin America [ 10 , 11 ], especially, for extraparenchymal NCC [ 12 ]. However, such assays typically require an a priori suspicion of T. solium infection.…”

Cerebrospinal fluid cytology in nonmalignant aseptic meningeal disorders

“…44 53 Increased risk for severe Strongyloidiasis is associated with marked immunosuppression. 44 53 Increased risk for severe Strongyloidiasis is associated with marked immunosuppression.…”

“…Nevertheless, molecular analysis of CSF can also accurately identify patients with extraparenchymal infection. 44 CNS infection may present with myelitis, encephalitis, and/or meningitis. 49 Antibodies against Toxocara spp.…”