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Prospective Comparison of Culture vs Genome Detection for Diagnosis of Enteroviral Meningitis in Childhood

Ronn E. Tanel, MD; Shaw-Yi Kao, PhD; Tina M. Niemiec; Michael J. Loeffelholz, PhD; Diane T. Holland, MS; Lorraine A. Shoaf, RN; Erin R. Stucky, MD; Jane C. Burns, MD
Arch Pediatr Adolesc Med. 1996;150(9):919-924. doi:10.1001/archpedi.1996.02170340033006.
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Objective:  To assess the sensitivity and specificity of a new polymerase chain reaction (PCR) assay with uninterrupted reverse transcription and complementary DNA amplification (RT-PCR) for the diagnosis of enteroviral (EV) meningitis in children.

Design:  A prospective, cohort study.

Settings:  Two medical centers: 1 university hospital and 1 children's hospital in San Diego County, California, during a 5-week period.

Patients:  All pediatric patients younger than 16 years who underwent a lumbar puncture for evaluation of possible meningitis.

Main Outcome Measures:  The results of cerebrospinal fluid (CSF) RT-PCR were compared with viral cultures and clinical histories.

Results:  During the 5-week period, 90 patients were entered into the study. Nonpolio EVs were cultured from 10% (9/90) of the patients from the following sites: CSF, 6.7% (6/90) of the patients; stool, 19% (4/21) of the patients; and throat swabs, 5.6% (1/18) of the patients. The EV genome was detected in the CSF by using RT-PCR in 7 of 9 EV culture–positive patients. The sensitivity and specificity of the CSF RT-PCR assay to detect EV meningitis were 77.8% and 100%, respectively. This compared with a sensitivity of 66.7% for detection of EV in CSF by viral culture alone.

Conclusion:  The new RT-PCR assay is a rapid and reliable method for the detection of EV infection in childhood.Arch Pediatr Adolesc Med. 1996;150:919-924

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