Clinical signs as a guide for performing HSV-PCR in correct diagnosis of herpes simplex virus encephalitis.

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dc.contributor.authorBehzad-Behbahani, Aen_US
dc.contributor.authorAbdolvahab, Aen_US
dc.contributor.authorGholamali, Y Pen_US
dc.contributor.authorRoshanak, Ben_US
dc.contributor.authorMahmood, Ren_US
dc.contributor.authorAbbas, B Ben_US
dc.date.accessioned2003-09-04en_US
dc.date.accessioned2009-06-03T10:38:00Z
dc.date.available2003-09-04en_US
dc.date.available2009-06-03T10:38:00Z
dc.date.issued2003-09-04en_US
dc.description.abstractBACKGROUND: Clinical criteria (symptoms) are not reliable enough to differentiate between different causes of encephalitis. The clinical presentation of herpes simplex virus encephalitis (HSVE) is not classically constant and in such a patient, therefore, it is vital to make early diagnosis. AIMS: To investigate satisfactory and crucial clinical signs as guide to perform HSV-PCR in a rapid diagnosis of herpes simplex virus encephalitis. MATERIAL AND METHODS: A total of 156 CSF specimens from 70 patients with clinically suspected HSVE or meningoencephalitis were tested. The criteria for cases suspected of HSVE were fever >380C, altered mental status and other critical manifestations. CSF features, irregularity in brain CT scan and MRI findings were also assessed. All the specimens were collected before and after Acyclovir treatment. Polymerase chain reaction was performed using primers, which amplified DNA sequences for both HSV-1 and HSV-2. STATISTICAL ANALYSIS: To analyze data, two-tailed Fisher's exact test and the X2-test with Yates' correction were used as appropriate. The odds ratio was used to express the strength of association between the clinical factors and the PCR results. RESULTS: HSV-DNA was detected in 18% of the specimens, belonging to 25.7% of the patients. Results indicate that the majority of the clinical symptoms are not specific to definitive clinical diagnosis of HSVE, except alteration in the level of consciousness--odds ratio [0.27 (0.07-0.96) (P=0.033)]; and lateralization sign--odds ratio [4.7 (0.98-22.6) (P=0.023)]. However, laboratory data, including total white blood cell count, especially the number of lymphocytes, and MRI findings could be suggested for HSV-PCR examination. CONCLUSION: At the first admission, a preliminary finding of at least two important clinical features mentioned above along with the pattern of CSF cell and differential counts could be sufficient to perform HSV-PCR which could ultimately result in a rapid and correct diagnosis of herpes simplex encephalitis.en_US
dc.description.affiliationClinical Virology, Organ Transplant Research Center, Shiraz University of Medical Sciences, Shiraz.en_US
dc.identifier.citationBehzad-Behbahani A, Abdolvahab A, Gholamali YP, Roshanak B, Mahmood R, Abbas BB. Clinical signs as a guide for performing HSV-PCR in correct diagnosis of herpes simplex virus encephalitis. Neurology India. 2003 Sep; 51(3): 341-4en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/120354
dc.language.isoengen_US
dc.source.urihttps://neurologyindia.comen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 and overen_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshCross-Sectional Studiesen_US
dc.subject.meshDNA, Viral --cerebrospinal fluiden_US
dc.subject.meshFemaleen_US
dc.subject.meshHerpes Simplex --cerebrospinal fluiden_US
dc.subject.meshHerpesvirus 1, Human --geneticsen_US
dc.subject.meshHerpesvirus 2, Human --geneticsen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPolymerase Chain Reactionen_US
dc.subject.meshSeverity of Illness Indexen_US
dc.titleClinical signs as a guide for performing HSV-PCR in correct diagnosis of herpes simplex virus encephalitis.en_US
dc.typeClinical Trialen_US
dc.typeJournal Articleen_US
dc.typeResearch Support, Non-U.S. Gov'ten_US
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