Abstract
Viral infections of the central nervous system (CNS) represent a challenge for early diagnosis and proper treatment of the disease. Different studies should be performed on the patient in order to arrive at an accurate diagnosis. The electroencephalogram, magnetic resonance imaging, viral culture, serological and cytochemical analysis are important tools to diagnose this disease. However, the polymerase chain reaction (PCR) or conventional PCR has become the gold standard for the diagnosis of viral encephalitis. Indeed, Real Time PCR (RT-PCR) equipments are replacing the conventional PCR ones. Faster results may be an explanation of this fact. Information obtained from dissociation curve analysis of the RT-PCR technique represents a highly sensitive and specific tool for the Herpes simplex (HSV), Varicela (VZV), Cytomegalovirus (CMV) and Enterovirus (EV) detection.
Highlights
Infections of the cerebral parenchyma cause the inflammation called encephalitis
Serial dilution experiments showed positive results even in 1:100 dilution rate for all samples. This allowed us to augment the number of samples analyzed and to check RT-polymerase chain reaction (PCR) reaction performance in clinical samples with low viral genetic load
445 Real Time PCR (RT-PCR) reactions were performed in Cerebrospinal fluid (CSF) samples from Intensive Care Unit patients of this hospital, during the entire 2012
Summary
Infections of the cerebral parenchyma cause the inflammation called encephalitis. Infectious agents most frequently found in these encephalitides are viruses, such as HSV, VZV, CMV and EV [1,2,3]. Viruses can cause an encephalitis by direct invasion of brain tissue or by post-infectious inflammatory type processes. Cerebrospinal fluid (CSF) analysis is a key tool in the diagnosis of CNS viral infections. Classical methods for the detection and subtyping of virus infections include enzyme-linked immunosorbent assay (ELISA), immune fluorescence microscopy (IFI) and isolation of the virus in cell cultures. At present, PCR has become the gold standard for the rapid diagnosis of viral encephalitis. RT-PCR, a modification of this technique, is being adopted as main method for detection of these viral agents. Higher sensibility, and the relative lack of complexity of the method would be explanations for this fact [1,2,3,4]
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