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- Title
Use of Staged Molecular Analysis to Determine Causes of Unexplained Central Nervous System Infections.
- Authors
Chien-Chin Hsu; Tokarz, Rafal; Briese, Thomas; Hung-Chin Tsai; Phenix-Lan Quan; Lipkin, W. Ian
- Abstract
No agent is implicated in most central nervous system (CNS) infections. To investigate cerebrospinal fluid samples from patients with CNS infections of unknown cause in 1 hospital in Taiwan, we used a staged molecular approach, incorporating techniques including multiplex MassTag PCR, 16S rRNA PCR, DNA microarray, and high-throughput pyrosequencing. We determined the infectious agent for 31 (24%) of 131 previously negative samples. Candidate pathogens were identified for 25 (27%) of 94 unexplained meningitis cases and 6 (16%) of 37 unexplained encephalitis cases. Epstein-Barr virus (18 infections) accounted for most of the identified agents in unexplained meningitis cases, followed by Escherichia coli (5), enterovirus (2), human herpesvirus 2 (1), and Mycobacterium tuberculosis. Herpesviruses were identified in samples from patients with unexplained encephalitis cases, including varicella-zoster virus (3 infections), human herpesvirus 1 (2), and cytomegalovirus (1). Our study confirms the power of multiplex MassTag PCR as a rapid diagnostic tool for identifying pathogens causing unexplained CNS infections.
- Subjects
CENTRAL nervous system infections; CEREBROSPINAL fluid; MENINGITIS; ENCEPHALITIS; CENTRAL nervous system viral diseases; HUMAN herpesvirus 2
- Publication
Emerging Infectious Diseases, 2013, Vol 19, Issue 9, p1470
- ISSN
1080-6040
- Publication type
Article
- DOI
10.3201/eid1909.130474