Diagnosing Central Nervous System Infections
Infections of the Central Nervous System (CNS) comprise meningitis (affecting the meninges), encephalitis (affecting brain parenchyma) and myelitis (affecting the spinal cord).
Meningitis is a medical emergency that requires rapid diagnosis and treatment. Clinical symptoms generally associate fever, headache, meningeal signs (stiff neck) and vomiting. The most common types of acute meningitis are bacterial and aseptic meningitis:
- Bacterial meningitis is a medical emergency that requires rapid diagnosis and treatment. The main causes beyond the neonatal period are S.pneumoniae, N meningitidis, H influenzae.
- Aseptic meningitis is typically self-limited, usually caused by viruses, the most frequent being enterovirus. Because aseptic meningitis may so closely resemble early acute bacterial meningitis, rapid biological diagnosis is crucial.
Detection of enterovirus in cerebrospinal fluid (CSF), after lumbar punction, enables clinical decisions such as patient discharge, and helps to avoid unnecessary antibiotic therapy or further more invasive investigations (1).
Encephalitis are mainly of viral origin. Symptoms include fever, headache, and altered mental status, often accompanied by seizures or focal neurologic deficits. Diagnosis requires CSF analysis and neuroimaging.
Herpes simplex virus is by far the most common cause of encephalitis. Other viruses involved are: Varicella Zoster virus, HIV, rabies virus, West Nile virus or other arboviruses.
1 Peigue-Lafeuille H et al. Interest of molecular diagnosis of viral meningoencephalitis. Spectra Biologie no. 154. Sept./Oct. 2006
bioMérieux offer for the diagnosis of CNS infection
Rapid identification of Enterovirus and Herpes Simplex Virus is key for efficient patient management: discharge of patients with enteroviral meningitis, appropriate antiviral therapy for HSV encephalitis.
bioMérieux offers real-time molecular assays as well as rapid automated and manual tests for detection of these life-threatening viruses.
- NucliSENS EasyQ® Enterovirus : real-time molecular test for same-day diagnosis of enteroviral meningitis.
Detection of Enterovirus in 3 to 4 hours
- VITEK® 2 / VITEK 2 Compact : the automated VITEK 2 Pneumo card enables identification and antibiotic susceptibility testing for pneumococcus within 6 to 8 hours
- Etest®: gradient technique for on-scale determination of MIC values - a prerequisite for the management of critical infections
- Slidex® Pneumo-Kit : detection of all S. pneumoniae serotypes within 2 minutes – directly from positive blood cultures or colonies
- Slidex Meningite-Kit 5 : detection of H. influenzae, S. pneumoniae, N. meningitidis antigens in cerebrospinal fluid 24 hours earlier than culture results
- API® strips: API NH strip for rapid identification of N. meningitides and H. influenzae
- ATB™ Haemo : rapid antibiotic susceptibility test for H. influenzae
- NucliSENS EasyQ HSV 1/2 : real-time molecular test for same-day diagnosis of encephalitis. Detection of Herpes Simplex virus in 3 to 4 hours
- VIDAS® system for automated testing of other viruses involved in post-infectious encephalitis : HIV, Varicella-Zoster, Cytomegalovirus
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