PCR in Meningoencephalitis Diagnosis

• Published in: Scandinavian journal of infectious diseases Vol. 32; no. 6; pp. 689 - 692
• Main Author: Dino Sgarabotto, Sabrina Buoro, Carlo Mengoli, Fabio Scano, Paolo Cadrobbi, Dario Di Luca, Giorgio Palù
• Format: Journal Article
• Language: English
• Published: Basingstoke Informa UK Ltd 2000; Taylor & Francis
• Subjects: Acute Disease; Adult; Bacterial diseases; Bacterial diseases of the nervous system. Bacterial myositis; Biological and medical sciences; Diagnosis, Differential; DNA, Bacterial - cerebrospinal fluid; DNA, Viral - cerebrospinal fluid; Gene Amplification; Herpesvirus 6, Human - genetics; Herpesvirus 6, Human - isolation & purification; Herpesvirus 7, Human - genetics; Herpesvirus 7, Human - isolation & purification; Human bacterial diseases; Human herpesvirus 6; Human herpesvirus 7; Humans; Infectious diseases; Male; Medical sciences; Meningoencephalitis - diagnosis; Meningoencephalitis - etiology; Mycoplasma Infections - diagnosis; Mycoplasma Infections - etiology; Mycoplasma pneumoniae; Mycoplasma pneumoniae - genetics; Mycoplasma pneumoniae - isolation & purification; Mycoplasma pneumoniae - pathogenicity; Polymerase Chain Reaction - methods; Roseolovirus Infections - diagnosis; Roseolovirus Infections - virology; Human; Nervous system diseases; Mycoplasma pneumoniae; Cerebrospinal fluid; Method; Mycoplasmataceae; Meningoencephalitis; Infection; Mollicutes; Case study; Polymerase chain reaction; Mycoplasmatales; Viral disease; Central nervous system disease; Bacteriosis; Bacteria; Diagnosis; Molecular biology
• ISSN: 0036-5548; 1651-1980
• DOI: 10.1080/003655400459649

Polymerase chain reaction (PCR) detection of a stretch of nucleic acid sequence of microbial origin from a clinical sample is not always diagnostic of disease unless the identified agent is a strict pathogen or its growth is documented. We describe here a case of acute meningoencephalitis in a 21-y-old man, in whom no pathogen was isolated by traditional bacterial or viral culture. Standard DNA PCR performed on the cerebrospinal fluid (CSF) identified the presence of 3 infectious agents: HHV-6, HHV-7 and Mycoplasma pneumoniae. Additional PCRs performed on CSF fractions along with gene transcript analysis proved the bystander role of the 2 herpesviruses and indicated M. pneumoniae as the relevant replicating agent, most likely playing to be a pathogenic role. Until this useful analysis becomes routine, clinicians should deal carefully with DNA PCR results, especially when assessing the aetiological role of agents , such as herpesviruses, which are known to undergo latency.