ABSTRACT
OBJECTIVES: When introduced into routine virological diagnosis of nervous system infections, PCR detection of viral DNA revealed the varicella-zoster virus (VZV) in cerebrospinal fluid (CSF) at much higher rates than expected. The aim of the study was to evaluate the frequency of VZV DNA detection in CSF of patients with neurological symptoms in correlation with their VZV-specific serological findings and clinical symptoms. MATERIAL AND METHODS: A total of 438 patients followed up in the neurology departments of the Motol and Královské Vinohrady University Hospitals and the Department of Infectious Diseases of the Bulovka University Hospital were screened for the presence of VZV-specific antibodies in serum and intrathecal antibodies in CSF. A home-brew nested PCR assay was used for detection of VZV DNA in CSF. Positive results were correlated with clinical findings. RESULTS: Intrathecal antibodies against VZV were detected in 19.6 % of the studied patients, VZV-specific IgM antibodies were present in serum of 17.3 % of the patients and VZV DNA was recorded in CSF of 9.4 % of the patients. The clinical diagnosis was confirmed in 16 patients positive for VZV DNA in CSF: encephalitis as a complication of neonatal varicella in a 2-week child; encephalitis or meningoencephalitis in 5 adult patients of whom three had a history of herpes zoster, one suffered from severe haemorrhagic focal encephalitis with fatal complications and one had encephalitis and myelitis; neuropathies in 4 patients, two with inflammatory polyneuropathy of unknown origin and two with brachial plexopathy, in one case preceded by herpes zoster; epileptic symptoms in 2 patients; multiple sclerosis in 3 patients and nonspecific symptoms of chronic fatigue in one patient. CONCLUSIONS: 1) PCR proved to be a suitable method for diagnosing VZV-mediated nervous system infections. 2) VZV DNA can be present in CSF of patients with a wide range of neurological symptoms, even with no history of either herpes zoster or varicella. 3) VZV DNA detection in CSF needs to be interpreted with caution and in correlation with case histories, clinical findings and electrophysiological and imaging data, especially in patients with chronic inflammatory disease receiving immunosuppressive therapy.
Subject(s)
Herpesvirus 3, Human/isolation & purification , Immunoglobulin M/cerebrospinal fluid , Nervous System Diseases/virology , Central Nervous System Viral Diseases/virology , DNA, Viral/cerebrospinal fluid , Humans , Nervous System Diseases/etiologyABSTRACT
OBJECTIVE: To identify and to examine the population groups at highest risk of acquiring HHV8 infection. MATERIAL AND METHODS: Indirect immunofluorescence test (IIF) for detection of IgG antibodies to the lytic antigen of HHV 8. RESULTS: In total 101 STD patients of a dermatovenerological clinic, 129 HIV - negative homosexual men - who have asked for voluntary HIV testing and 37 patients with repeated blood transfusions were tested. The highest number of patients - 13 (10 %) with IgG antibodies to the lytic antigen of HHV 8 was found in the group of HIV - negative homosexual men. CONCLUSIONS: In the Czech Republic are at highest risk of HHV 8 infection (except HIV positive persons), HIV negative men.
Subject(s)
Herpesviridae Infections , Herpesvirus 8, Human , Czech Republic , HIV Infections , Humans , IncidenceABSTRACT
A 9-month-old boy with impetigious blepharitis of the right eye was admitted to the Department of children and adolescents of the Kralovske Vinohrady University Hospital. NA isolated from lesion fluid was screened using real-time PCR based HSV 1/2 detection kit (Roche). Differentiation between HSV types 1 and 2 in this assay is based on variation of double-stranded DNA melting temperature (Tm), being 54 degrees C +/- 2,5 degrees C for HSV-1 and 66,5 degrees C +/- 2,5 degrees C for HSV-2. Since the amplified NA from the sample showed an atypical Tm of 59 degrees C, nested PCR was used for futher analysis: the presence of HSV-1 NA was confirmed by the latter. In spite of the atypical Tm value, the eyelid infection was responsive to acyclovir and resolved after intravenous Herpesin given for 5 days.
