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Chapter 50 : Molecular Approaches to the Diagnosis of Meningitis and Encephalitis

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Abstract:

This chapter reviews various diagnostic tests available for central nervous system (CNS) infections and provides a detailed discussion of specific molecular approaches to the most common organisms causing meningitis and encephalitis in the United States. A vast array of organisms have been associated with encephalitis, including bacteria, fungi, viruses, and protozoa. Just as meningitis and encephalitis localize to distinct compartments of the CNS, the pathogens causing these two syndromes differ, and the respective microbiologies of meningitis and encephalitis are discussed separately. While the chapter focuses on the use of molecular assays for diagnosis of CNS infection, traditional microbiological diagnostic approaches continue to play an important role in pathogen identification and are complementary to nucleic acid amplification techniques. A DNA probe array has been developed for the simultaneous identification of herpesviruses, enteroviruses, and flaviviruses after several PCR amplifications. Nucleic acid amplification techniques have markedly improved the identification of CNS infections caused by viral and fastidious bacterial pathogens. Molecular techniques such as PCR allow rapid diagnosis, with consequent improvement of outcomes and cost savings. Results of molecular diagnostic testing for CNS infections must be interpreted in the context of the individual patient presentation and clinical illness, and close cooperation between the laboratory and the clinician is required for optimal use of these technologies.

Citation: Bloch K, Tang Y. 2011. Molecular Approaches to the Diagnosis of Meningitis and Encephalitis, p 767-784. In Persing D, Tenover F, Tang Y, Nolte F, Hayden R, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555816834.ch50

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Nucleic Acid Amplification Techniques
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Subacute Sclerosing Panencephalitis
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Reverse Transcriptase PCR
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Eastern equine encephalitis virus
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Tables

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TABLE 1

Relatively common causes of meningoencephalitis in immunocompetent patients

Citation: Bloch K, Tang Y. 2011. Molecular Approaches to the Diagnosis of Meningitis and Encephalitis, p 767-784. In Persing D, Tenover F, Tang Y, Nolte F, Hayden R, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555816834.ch50
Generic image for table
TABLE 2

Less common causes of meningoencephalitis in immunocompetent patients

Citation: Bloch K, Tang Y. 2011. Molecular Approaches to the Diagnosis of Meningitis and Encephalitis, p 767-784. In Persing D, Tenover F, Tang Y, Nolte F, Hayden R, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555816834.ch50

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