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We tested 2233 consecutive CSF samples from 2162 patients.A positive PCR result was obtained in 143 patients,including 22 from the Oxford cohort. Logistic regression analysis of the Oxford cohort showed that fever,a virus-specific rash,and a CSF white-cell count of 5/uL or more were independent predictors of a positive PCR result.The likelihood ratio for a definite diagnosis of viral infection of the CNS in a patient with a positive PCR result,relative to a negative PCR result,was 88-w(95%CI 20-6- 378).The likelihood ratio for a possible diagnosis of viral infection of the CNS in a patient with a negative PCR result,relative to a positive PCR result,was 0-10(0-03-0.39).A patient with a positive PCR result was 88 times as likely to have a definite diagnosis of viral infection of the CNS as a patient with a negative PCR result.A negative PCR result can be used with moderate confidence to rule out a diagnosis of viral infection of the CNS.We believe that PCR will become the first-line diagnostic test for viral meningitis and encephalitis. |
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cerebrospinal fluid
cerebrospinal fluid,abnormal
encephalitis
encephalitis,viral
enterovirus
enterovirus infection of CNS
herpes simplex encephalitis
herpes simplex encephalitis,diagnosis of
herpes simplex virus
herpes virus infection
meningitis,aseptic
meningitis,rapid diagnosis
neurologic disease,diagnoses of
polymerase chain reaction
review article
varicella zoster virus
viral infection
viral infection,CNS
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