The investigation of herpes group viruses in patients with aseptic meningitis/encephalitis

Viral meningitis is a central nervous system infection characterized by signs and symptoms of meningeal inflammation in the absence of positive bacterial and fungal cultures. Viral encephalitis is defined as a febrile illness with evidence of brain parenchymal dysfunction as manifested by an altered state of consciousness and/or objective signs of neurological dysfunction. To investigate the incidence of Herpes Simplex Virus infections among patient with aseptic meningitis or encephalitis in our region, 108 patients with aseptic meningitis and 80 patients with encephalitis; total 188 patients included in this study. HSV-DNA was detected by consensus Herpes Simplex Virus Polimerase Chain Reaction in Cerebrospinal fluid (CSF) samples. HSV typing was made by restriction enzyme analysis. In addition, intrathecal synthesis of HSV-1 and HSV-2 specific IgG antibodies were examined by ELISA (Enzyme Linked Immun Assay) test. HSV-1 DNA was detected in 4 (% 2,1) of total 188 patients. HSV-1 IgG antibody was found in 3 of CSF samples. Of the 3 patients, 2 patients were also positive for HSV-1 DNA. Nor HSV-2 DNA neither HSV-2 specific IgG were present in our patients. In conclusion, 5 (% 2,6) of total 188 patients has been found to have HSV-1 infections. The early diagnosis of HSV infections is extremely important in central nervous system (CNS) infections due to HSV, as specific antiviral treatment dramatically reduces the mortality. In our study it is concluded that PCR test is rapid and reliable in early diagnosis of CNS infections. The measurement of HSV-1 IgG antibody only in CSF has limited diagnostic value and it should be evaluated with PCR test results.