Role of the virology laboratory in diagnosis and management of patients with central nervous system disease

T. Chonmaitree, C. D. Baldwin, H. L. Lucia

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

A number of viruses cause acute central nervous system disease. The two major clinical presentations are aseptic meningitis and the less common meningoencephalitis. Clinical virology laboratories are now more widely available than a decade ago; they can be operated on a modest scale and can be tailored to the needs of the patients they serve. Most laboratories can provide diagnostic information on diseases caused by enteroviruses, herpesviruses, and human immunodeficiency virus. Antiviral therapy for herpes simplex virus is now available. By providing a rapid diagnostic test or isolation of the virus or both, the virology laboratory plays a direct role in guiding antiviral therapy for patients with herpes simplex encephalitis. Although there is no specific drug available for enteroviruses, attention needs to be paid to these viruses since they are the most common cause of nonbacterial meningitis and the most common pathogens causing hospitalization sepsis in young infants in the United States during the warm months of the year. When the virology laboratory maximizes the speed of viral detection or isolation, it can made a significant impact on management of these patients. Early viral diagnosis benefits patients with enteroviral meningitis, most of whom are hospitalized and treated for bacterial sepsis or meningitis or both; these patients have the advantage of early withdrawal of antibiotics and intravenous therapy, early hospital discharge, and avoidance of the risks and costs of unnecessary tests and treatment. Enteroviral infection in young infants also is a risk factor for possible long-term sequelae. For compromised patients, the diagnostic information helps in selecting specific immunoglobulin therapy. Good communication between the physician and the laboratory will result in the most benefit to patients with central nervous system viral infection.

Original languageEnglish (US)
Pages (from-to)1-14
Number of pages14
JournalClinical Microbiology Reviews
Volume2
Issue number1
StatePublished - 1989

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Virology
Clinical Laboratory Techniques
Central Nervous System Diseases
Meningitis
Enterovirus
Viruses
Antiviral Agents
Sepsis
Central Nervous System Viral Diseases
Herpes Simplex Encephalitis
Aseptic Meningitis
Meningoencephalitis
Passive Immunization
Herpesviridae
Simplexvirus
Therapeutics
Routine Diagnostic Tests
Early Diagnosis
Hospitalization
Communication

ASJC Scopus subject areas

  • Microbiology

Cite this

Role of the virology laboratory in diagnosis and management of patients with central nervous system disease. / Chonmaitree, T.; Baldwin, C. D.; Lucia, H. L.

In: Clinical Microbiology Reviews, Vol. 2, No. 1, 1989, p. 1-14.

Research output: Contribution to journalArticle

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