Herpes Simplex Virus Encephalitis: Laboratory Evaluations and Their Diagnostic Significance

Laboratory procedures were compared with brain biopsy findings in 113 biopsy-proven patients with herpes simplex virus (HSV) encephalitis and 93 biopsy-negative individuals. Examinations of brain tissue by histopathology, immunofluorescence, and electron microscopy demonstrated evidence of HSV infec...

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Bibliographic Details
Published in:The Journal of infectious diseases 1982-06, Vol.145 (6), p.829-836
Main Authors: Nahmias, A. J., Whitley, R. J., Visintine, A. N., Takei, Y., Alford, C. A.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Antibodies
Antibodies, Viral - analysis
Antibodies, Viral - cerebrospinal fluid
Biopsies
Biopsy
Brain
Brain - microbiology
Cerebrospinal fluid
Child
Encephalitis
Encephalitis - diagnosis
Encephalitis - immunology
Fluorescent Antibody Technique
Herpes Simplex - diagnosis
Herpes Simplex - immunology
herpes simplex virus
Human herpesvirus 1
Humans
Infant
Infections
Recurrence
Simplexvirus
Simplexvirus - immunology
Simplexvirus - isolation & purification
Specimens
Viral Disease
Viruses
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Description
Summary:Laboratory procedures were compared with brain biopsy findings in 113 biopsy-proven patients with herpes simplex virus (HSV) encephalitis and 93 biopsy-negative individuals. Examinations of brain tissue by histopathology, immunofluorescence, and electron microscopy demonstrated evidence of HSV infection in 56%, 70%, and 45% of proven cases and apparently false-positive results in 14%,9%, and 2% of those biopsynegative. Serologic assessments revealed that HSV encephalitis occurred as both a primary (30%) and recurrent (70%) infection. Among patients with HSV encephalitis, 28% failed to seroconvert or seroboost within one month of the onset of disease. Titers of passive hemagglutinating and IgG immunofluorescent antibodies increased fourfold in the cerebrospinal fluid in 74% and 94%, respectively, of patients with proven disease. Similar percentages of patients had antibody ratios in serum and cerebrospinal fluid of ≤20 over the same interval. These data indicate the need for development of noninvasive diagnostic procedures.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/145.6.829