Detection of enterovirus genome in cerebrospinal fluid of children with aseptic meningitis; the relationship with interferon - gamma

ABSTRACT

Aseptic meningitis is one of the most common inflammatory disorders of the meninges. The most common viruses causing aseptic meningitis are the enteroviruses, which account for more than half the cases. We analyzed the combined diagnostic utility of reverse transcriptase polymerase chain reaction [RT- PCR] and the level of interferon gamma [IFN-gamma] in cerebrospinal fluid [CSF] specimens obtained from children with aseptic meningitis, for the diagnosis of enterovirus. Out of 33 CSF samples, 9 [27.2%] gave positive results for enterovirus RNA by RTPCR and 15 [45.4%] gave detectable level of IFN-gamma, ranging from 15.6 up to more than 1000 picogram/ ml. The mean CSF IFN-gamma concentration was 243.73 picogram/ml. which was significantly higher in CSF samples gave positive results for enterovirus genome by RT- PCR [384.3 picogram /ml] when compared with CSF samples gave negative results for enterovirus genome [56.6 picogram /ml],the results was statistically significant [p=0.0001]. Overall, data from previous reports and from the present study indicated that RT-PCR for enteroviral meningitis is an important tool in the diagnosis of children with aseptic meningitis and IFN-gamma is produced in the CSF in response to viral infection, and about half of the patients with aseptic meningitis contain IFN-gamma in the cerebrospinal fluids