Detection of herpes viruses in the cerebrospinal fluid of adults with suspected viral meningitis in Malawi

Benjamin, L. A., Kelly, M., Cohen, Danielle, Neuhann, F., Galbraith, S., Mallewa, M., Hopkins, M., Hart, I. J., Guiver, M., Lalloo, David ORCID: https://orcid.org/0000-0001-7680-2200, Heyderman, R. S. and Solomon, T. (2013) 'Detection of herpes viruses in the cerebrospinal fluid of adults with suspected viral meningitis in Malawi'. Infection, Vol 41, Issue 1, pp. 27-31.

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Abstract

Purpose

We looked for herpes simplex virus types 1 and 2 (HSV-1 and HSV-2, respectively), varicella zoster virus (VZV), Epstein–Barr virus (EBV) and cytomegalovirus (CMV) DNA in Malawian adults with clinically suspected meningitis.

Methods

We collected cerebrospinal fluid (CSF) from consecutive adults admitted with clinically suspected meningitis to Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi, for a period of 3 months. Those with proven bacterial or fungal meningitis were excluded. Real-time polymerase chain reaction (PCR) was performed on the CSF for HSV-1 and HSV-2, VZV, EBV and CMV DNA.

Results

A total of 183 patients presented with clinically suspected meningitis. Of these, 59 (32 %) had proven meningitis (bacterial, tuberculous or cryptococcal), 39 (21 %) had normal CSF and 14 (8 %) had aseptic meningitis. For the latter group, a herpes virus was detected in 9 (64 %): 7 (50 %) had EBV and 2 (14 %) had CMV, all were human immunodeficiency virus (HIV)-positive. HSV-2 and VZV were not detected. Amongst those with a normal CSF, 8 (21 %) had a detectable herpes virus, of which 7 (88 %) were HIV-positive.

Conclusions

The spectrum of causes of herpes viral meningitis in this African population is different to that in Western industrialised settings, with EBV being frequently detected in the CSF. The significance of this needs further investigation.

Item Type:	Article
Subjects:	WB Practice of Medicine > Therapeutics > WB 377 Spinal, cisternal and ventricular puncture WC Communicable Diseases > Virus Diseases > Infectious Viral Skin Diseases > WC 575 Herpes zoster WC Communicable Diseases > Virus Diseases > Infectious Viral Skin Diseases > WC 578 Herpes simplex WL Nervous System > WL 140 Nervous system diseases (General) WL Nervous System > WL 200 Meninges. Blood-brain barrier
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1007/s15010-012-0292-z
Depositing User:	Lynn Roberts-Maloney
Date Deposited:	12 Feb 2015 14:41
Last Modified:	06 Feb 2018 13:08
URI:	https://archive.lstmed.ac.uk/id/eprint/4899

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