Diagnostic Strategy Used To Establish Etiologies of Encephalitis in a Prospective Cohort of Patients in England

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Published inJournal of Clinical Microbiology Vol. 49; no. 10; pp. 3576 - 3583
Main Authors Ambrose, H. E., Granerod, J., Clewley, J. P., Davies, N. W. S., Keir, G., Cunningham, R., Zuckerman, M., Mutton, K. J., Ward, K. N., Ijaz, S., Crowcroft, N. S., Brown, D. W. G.
Format Journal Article
LanguageEnglish
Published Washington, DC American Society for Microbiology 01.10.2011
Subjects
Adolescent
Adult
Algorithms
Antibodies - cerebrospinal fluid
Bacterial Infections - diagnosis
Bacterial Infections - microbiology
Biological and medical sciences
Cerebrospinal Fluid - immunology
Child
Child, Preschool
Clinical Laboratory Techniques - methods
Cohort Studies
Diagnosis, Differential
Encephalitis - diagnosis
Encephalitis - etiology
England
Female
Fundamental and applied biological sciences. Psychology
Humans
Immune System Diseases - diagnosis
Male
Microbiology
Middle Aged
Prospective Studies
Virology
Virus Diseases - diagnosis
Virus Diseases - virology
Young Adult
England
United Kingdom
Great Britain
Europe
Western Europe
Human
Encephalitis
Nervous system diseases
Central nervous system disease
Cerebral disorder
Online AccessGet full text
ISSN0095-1137
1098-660X
1070-633X
1098-660X
DOI10.1128/JCM.00862-11

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Abstract Article Usage Stats Services JCM Citing Articles Google Scholar PubMed Related Content Social Bookmarking CiteULike Delicious Digg Facebook Google+ Mendeley Reddit StumbleUpon Twitter current issue JCM About JCM Subscribers Authors Reviewers Advertisers Inquiries from the Press Permissions & Commercial Reprints ASM Journals Public Access Policy JCM RSS Feeds 1752 N Street N.W. • Washington DC 20036 202.737.3600 • 202.942.9355 fax • journals@asmusa.org Print ISSN: 0095-1137 Online ISSN: 1098-660X Copyright © 2014 by the American Society for Microbiology.   For an alternate route to JCM .asm.org, visit: JCM       
AbstractList The laboratory diagnostic strategy used to determine the etiology of encephalitis in 203 patients is reported. An etiological diagnosis was made by first-line laboratory testing for 111 (55%) patients. Subsequent testing, based on individual case reviews, resulted in 17 (8%) further diagnoses, of which 12 (71%) were immune-mediated and 5 (29%) were due to infection. Seventy-five cases were of unknown etiology. Sixteen (8%) of 203 samples were found to be associated with either N-methyl-d-aspartate receptor or voltage-gated potassium channel complex antibodies. The most common viral causes identified were herpes simplex virus (HSV) (19%) and varicella-zoster virus (5%), while the most important bacterial cause was Mycobacterium tuberculosis (5%). The diagnostic value of testing cerebrospinal fluid (CSF) for antibody was assessed using 139 samples from 99 patients, and antibody was detected in 46 samples from 37 patients. Samples collected at 14 to 28 days were more likely to be positive than samples taken 0 to 6 days postadmission. Three PCR-negative HSV cases were diagnosed by the presence of virus-specific antibody in the central nervous system (CNS). It was not possible to make an etiological diagnosis for one-third of the cases; these were therefore considered to be due to unknown causes. Delayed sampling did not contribute to these cases. Twenty percent of the patients with infections with an unknown etiology showed evidence of localized immune activation within the CNS, but no novel viral DNA or RNA sequences were found. We conclude that a good standard of clinical investigation and thorough first-line laboratory testing allows the diagnosis of most cases of infectious encephalitis; testing for CSF antibodies allows further cases to be diagnosed. It is important that testing for immune-mediated causes also be included in a diagnostic algorithm.The laboratory diagnostic strategy used to determine the etiology of encephalitis in 203 patients is reported. An etiological diagnosis was made by first-line laboratory testing for 111 (55%) patients. Subsequent testing, based on individual case reviews, resulted in 17 (8%) further diagnoses, of which 12 (71%) were immune-mediated and 5 (29%) were due to infection. Seventy-five cases were of unknown etiology. Sixteen (8%) of 203 samples were found to be associated with either N-methyl-d-aspartate receptor or voltage-gated potassium channel complex antibodies. The most common viral causes identified were herpes simplex virus (HSV) (19%) and varicella-zoster virus (5%), while the most important bacterial cause was Mycobacterium tuberculosis (5%). The diagnostic value of testing cerebrospinal fluid (CSF) for antibody was assessed using 139 samples from 99 patients, and antibody was detected in 46 samples from 37 patients. Samples collected at 14 to 28 days were more likely to be positive than samples taken 0 to 6 days postadmission. Three PCR-negative HSV cases were diagnosed by the presence of virus-specific antibody in the central nervous system (CNS). It was not possible to make an etiological diagnosis for one-third of the cases; these were therefore considered to be due to unknown causes. Delayed sampling did not contribute to these cases. Twenty percent of the patients with infections with an unknown etiology showed evidence of localized immune activation within the CNS, but no novel viral DNA or RNA sequences were found. We conclude that a good standard of clinical investigation and thorough first-line laboratory testing allows the diagnosis of most cases of infectious encephalitis; testing for CSF antibodies allows further cases to be diagnosed. It is important that testing for immune-mediated causes also be included in a diagnostic algorithm.
The laboratory diagnostic strategy used to determine the etiology of encephalitis in 203 patients is reported. An etiological diagnosis was made by first-line laboratory testing for 111 (55%) patients. Subsequent testing, based on individual case reviews, resulted in 17 (8%) further diagnoses, of which 12 (71%) were immune-mediated and 5 (29%) were due to infection. Seventy-five cases were of unknown etiology. Sixteen (8%) of 203 samples were found to be associated with either N-methyl-d-aspartate receptor or voltage-gated potassium channel complex antibodies. The most common viral causes identified were herpes simplex virus (HSV) (19%) and varicella-zoster virus (5%), while the most important bacterial cause was Mycobacterium tuberculosis (5%). The diagnostic value of testing cerebrospinal fluid (CSF) for antibody was assessed using 139 samples from 99 patients, and antibody was detected in 46 samples from 37 patients. Samples collected at 14 to 28 days were more likely to be positive than samples taken 0 to 6 days postadmission. Three PCR-negative HSV cases were diagnosed by the presence of virus-specific antibody in the central nervous system (CNS). It was not possible to make an etiological diagnosis for one-third of the cases; these were therefore considered to be due to unknown causes. Delayed sampling did not contribute to these cases. Twenty percent of the patients with infections with an unknown etiology showed evidence of localized immune activation within the CNS, but no novel viral DNA or RNA sequences were found. We conclude that a good standard of clinical investigation and thorough first-line laboratory testing allows the diagnosis of most cases of infectious encephalitis; testing for CSF antibodies allows further cases to be diagnosed. It is important that testing for immune-mediated causes also be included in a diagnostic algorithm.
The laboratory diagnostic strategy used to determine the etiology of encephalitis in 203 patients is reported. An etiological diagnosis was made by first-line laboratory testing for 111 (55%) patients. Subsequent testing, based on individual case reviews, resulted in 17 (8%) further diagnoses, of which 12 (71%) were immune-mediated and 5 (29%) were due to infection. Seventy-five cases were of unknown etiology. Sixteen (8%) of 203 samples were found to be associated with either N -methyl- d -aspartate receptor or voltage-gated potassium channel complex antibodies. The most common viral causes identified were herpes simplex virus (HSV) (19%) and varicella-zoster virus (5%), while the most important bacterial cause was Mycobacterium tuberculosis (5%). The diagnostic value of testing cerebrospinal fluid (CSF) for antibody was assessed using 139 samples from 99 patients, and antibody was detected in 46 samples from 37 patients. Samples collected at 14 to 28 days were more likely to be positive than samples taken 0 to 6 days postadmission. Three PCR-negative HSV cases were diagnosed by the presence of virus-specific antibody in the central nervous system (CNS). It was not possible to make an etiological diagnosis for one-third of the cases; these were therefore considered to be due to unknown causes. Delayed sampling did not contribute to these cases. Twenty percent of the patients with infections with an unknown etiology showed evidence of localized immune activation within the CNS, but no novel viral DNA or RNA sequences were found. We conclude that a good standard of clinical investigation and thorough first-line laboratory testing allows the diagnosis of most cases of infectious encephalitis; testing for CSF antibodies allows further cases to be diagnosed. It is important that testing for immune-mediated causes also be included in a diagnostic algorithm.
Article Usage Stats Services JCM Citing Articles Google Scholar PubMed Related Content Social Bookmarking CiteULike Delicious Digg Facebook Google+ Mendeley Reddit StumbleUpon Twitter current issue JCM About JCM Subscribers Authors Reviewers Advertisers Inquiries from the Press Permissions & Commercial Reprints ASM Journals Public Access Policy JCM RSS Feeds 1752 N Street N.W. • Washington DC 20036 202.737.3600 • 202.942.9355 fax • journals@asmusa.org Print ISSN: 0095-1137 Online ISSN: 1098-660X Copyright © 2014 by the American Society for Microbiology.   For an alternate route to JCM .asm.org, visit: JCM       
Author H. E. Ambrose
N. S. Crowcroft
G. Keir
K. J. Mutton
J. P. Clewley
J. Granerod
S. Ijaz
D. W. G. Brown
K. N. Ward
N. W. S. Davies
M. Zuckerman
R. Cunningham
on behalf of the UK Aetiology of Encephalitis Study Group
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Cites_doi 10.1136/jnnp.2004.045336
10.1002/jmv.1890330207
10.1086/648419
10.1016/j.cell.2010.11.054
10.1002/(SICI)1096-9071(199712)53:4<324::AID-JMV3>3.0.CO;2-9
10.1017/S0950268810000725
10.1080/09602010600989620
10.1128/JVI.02301-08
10.1371/journal.ppat.1000163
10.1086/367841
10.1086/422650
10.1007/s10096-009-0799-0
10.1016/S1473-3099(10)70222-X
10.1186/1471-2334-4-33
10.1016/j.jcv.2009.01.005
10.1128/JCM.02115-06
10.7861/clinmedicine.7-6-646
10.1111/j.1468-1331.2005.01126.x
10.3201/eid0902.020218
10.1016/S0272-2712(03)00084-2
10.1016/S1474-4422(09)70324-2
10.1177/000456329002700503
10.1002/ana.21756
10.1093/brain/awq113
10.1007/s00415-005-0770-7
10.1016/j.jneuroim.2010.11.007
10.1016/j.jneuroim.2007.01.002
10.3201/eid1702.100856
10.1128/CMR.17.4.903-925.2004
10.1016/S0891-5520(05)70186-0
10.1086/509330
10.1086/444396
10.1212/01.wnl.0000191407.81333.00
10.1016/j.jim.2006.01.015
10.1016/0140-6736(91)92155-U
10.1136/jnnp.2007.129098
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Ambrose, Helen E
Lin, Jean-Pierre
Mutton, Kenneth J
Tong, William
Walsh, Amanda L
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Lim, Ming
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Encephalitis
Nervous system diseases
Central nervous system disease
Cerebral disorder
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These authors contributed equally to this work.
Present address: Institute for Animal Health, Woking, United Kingdom.
Present address: Chelsea & Westminster Hospital, London, United Kingdom.
Present address: King's College Hospital NHS Foundation Trust, London, United Kingdom.
Present address: Ontario Agency for Health Protection and Promotion, Toronto, Ontario, Canada.
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e_1_3_2_23_2
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e_1_3_2_25_2
e_1_3_2_9_2
e_1_3_2_15_2
e_1_3_2_8_2
e_1_3_2_16_2
e_1_3_2_37_2
e_1_3_2_7_2
e_1_3_2_17_2
e_1_3_2_6_2
e_1_3_2_18_2
e_1_3_2_19_2
e_1_3_2_30_2
e_1_3_2_32_2
e_1_3_2_10_2
e_1_3_2_31_2
e_1_3_2_5_2
e_1_3_2_11_2
e_1_3_2_34_2
e_1_3_2_4_2
e_1_3_2_12_2
e_1_3_2_33_2
e_1_3_2_3_2
e_1_3_2_13_2
e_1_3_2_36_2
e_1_3_2_2_2
e_1_3_2_14_2
e_1_3_2_35_2
References_xml – ident: e_1_3_2_4_2
  doi: 10.1136/jnnp.2004.045336
– ident: e_1_3_2_20_2
  doi: 10.1002/jmv.1890330207
– ident: e_1_3_2_25_2
  doi: 10.1086/648419
– ident: e_1_3_2_28_2
  doi: 10.1016/j.cell.2010.11.054
– ident: e_1_3_2_26_2
  doi: 10.1002/(SICI)1096-9071(199712)53:4<324::AID-JMV3>3.0.CO;2-9
– ident: e_1_3_2_14_2
  doi: 10.1017/S0950268810000725
– ident: e_1_3_2_12_2
  doi: 10.1080/09602010600989620
– ident: e_1_3_2_35_2
  doi: 10.1128/JVI.02301-08
– ident: e_1_3_2_34_2
  doi: 10.1371/journal.ppat.1000163
– ident: e_1_3_2_9_2
  doi: 10.1086/367841
– ident: e_1_3_2_15_2
  doi: 10.1086/422650
– ident: e_1_3_2_8_2
  doi: 10.1007/s10096-009-0799-0
– ident: e_1_3_2_11_2
  doi: 10.1016/S1473-3099(10)70222-X
– ident: e_1_3_2_22_2
  doi: 10.1186/1471-2334-4-33
– ident: e_1_3_2_17_2
  doi: 10.1016/j.jcv.2009.01.005
– ident: e_1_3_2_36_2
  doi: 10.1128/JCM.02115-06
– ident: e_1_3_2_13_2
  doi: 10.7861/clinmedicine.7-6-646
– ident: e_1_3_2_31_2
  doi: 10.1111/j.1468-1331.2005.01126.x
– ident: e_1_3_2_5_2
  doi: 10.3201/eid0902.020218
– ident: e_1_3_2_29_2
  doi: 10.1016/S0272-2712(03)00084-2
– ident: e_1_3_2_24_2
  doi: 10.1016/S1474-4422(09)70324-2
– ident: e_1_3_2_32_2
  doi: 10.1177/000456329002700503
– ident: e_1_3_2_7_2
  doi: 10.1002/ana.21756
– ident: e_1_3_2_18_2
  doi: 10.1093/brain/awq113
– ident: e_1_3_2_21_2
  doi: 10.1007/s00415-005-0770-7
– ident: e_1_3_2_37_2
  doi: 10.1016/j.jneuroim.2010.11.007
– ident: e_1_3_2_3_2
  doi: 10.1016/j.jneuroim.2007.01.002
– ident: e_1_3_2_19_2
  doi: 10.3201/eid1702.100856
– ident: e_1_3_2_6_2
  doi: 10.1128/CMR.17.4.903-925.2004
– ident: e_1_3_2_33_2
  doi: 10.1016/S0891-5520(05)70186-0
– ident: e_1_3_2_10_2
  doi: 10.1086/509330
– ident: e_1_3_2_16_2
  doi: 10.1086/444396
– ident: e_1_3_2_23_2
  doi: 10.1212/01.wnl.0000191407.81333.00
– ident: e_1_3_2_27_2
  doi: 10.1016/j.jim.2006.01.015
– ident: e_1_3_2_2_2
  doi: 10.1016/0140-6736(91)92155-U
– ident: e_1_3_2_30_2
  doi: 10.1136/jnnp.2007.129098
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Snippet Article Usage Stats Services JCM Citing Articles Google Scholar PubMed Related Content Social Bookmarking CiteULike Delicious Digg Facebook Google+ Mendeley...
The laboratory diagnostic strategy used to determine the etiology of encephalitis in 203 patients is reported. An etiological diagnosis was made by first-line...
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SubjectTerms Adolescent
Adult
Algorithms
Antibodies - cerebrospinal fluid
Bacterial Infections - diagnosis
Bacterial Infections - microbiology
Biological and medical sciences
Cerebrospinal Fluid - immunology
Child
Child, Preschool
Clinical Laboratory Techniques - methods
Cohort Studies
Diagnosis, Differential
Encephalitis - diagnosis
Encephalitis - etiology
England
Female
Fundamental and applied biological sciences. Psychology
Humans
Immune System Diseases - diagnosis
Male
Microbiology
Middle Aged
Prospective Studies
Virology
Virus Diseases - diagnosis
Virus Diseases - virology
Young Adult
Title Diagnostic Strategy Used To Establish Etiologies of Encephalitis in a Prospective Cohort of Patients in England
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https://pubmed.ncbi.nlm.nih.gov/PMC3187347
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