Molecular characterisation of enteroviruses and clinical findings from a cluster of paediatric viral meningitis cases in Tshwane, South Africa 2010–2011

Wolfaardt, Marianne; Büchner, A.; Myburgh, Marcelle; Avenant, Theunis; Plessis, Nicolette Marie Du; Taylor, Maureen B.

doi:10.1016/j.jcv.2014.08.001

Cited by 12 publications

(22 citation statements)

References 27 publications

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“…PCR for HSV-2 DNA is usually positive in the CSF of patients with initial episodes of meningitis. PCR is also is positive in approximately 80% of patients with benign recurrent meningitis caused by lymphocytic choriomeningitis virus (2,18).…”

Section: Molecular Methods and Applicationsmentioning

confidence: 99%

“…Enteroviruses account for 85 to 95% of aseptic meningitis (3,18). Enteroviruses are single-stranded RNA viruses and, along with rhinoviruses, represent a major group in the genus Enterovirus in the family Picornaviridae.…”

Section: Viral Meningitismentioning

confidence: 99%

“…Its distribution covers large geographical areas, and infections are more common in children. On the other hand, no seasonal preference has been reported for HSV and HIV (18). Table 2 describes the recently published surveys and outbreaks of acute meningitis worldwide.…”

Section: Viral Meningitismentioning

confidence: 99%

“…Since result values differ in response to the different types of microorganisms involved, assays such as glucose, lactate, and various proteins assays can provide diagnostic information (Table 4) and help classify the type of meningitis, but results from cytology and chemistry laboratories cannot conclusively determine whether the infection is bacterial, viral, fungal, or parasitic due to similarity of results that may be obtained in response to infections by different microorganism types. Confirmatory tests should be performed (2,18).…”

Section: Chemical Examinationmentioning

confidence: 99%

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Infectious Meningitis

Zueter

Zaiter

2015

Clinical Microbiology Newsletter

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Infectious meningitis is a large public health concern, especially in children and immunocompromised patients. Although the epidemiology of meningitis has shown significant decline in past decades, partly due to the introduction of vaccines, outbreaks are still reported worldwide. Diagnosis of meningitis is of critical importance, and it is considered to be one of the most urgent of the microbiological medical emergencies. In order to improve the treatment strategy, various diagnostic methods have been developed to detect the presence of infectious agents that cause meningitis, as well as their antibiotic resistance patterns. This article aims to enhance the understanding of meningitis and to highlight the most current updates that describe outbreaks of meningitis and the subsequent investigations. We also describe the current diagnosis and treatment options. CMN

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Section: Molecular Methods and Applicationsmentioning

confidence: 99%

Section: Viral Meningitismentioning

confidence: 99%

Section: Viral Meningitismentioning

confidence: 99%

Section: Chemical Examinationmentioning

confidence: 99%

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Infectious Meningitis

Zueter

Zaiter

2015

Clinical Microbiology Newsletter

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“…Typing of enteroviruses was carried out using conventional nested RT-PCR of the VP1 region, followed by nucleotide sequence analysis, as described by Wolfaardt et al 2 The reverse transcription reaction consisted of the following: 1 x reaction buffer (Thermo Scientific, Waltham, USA), 0.5 mM deoxyribonucleotide triphosphates (dNTPs) (Thermo Scientific), 600 pmol random hexamers (Roche Diagnostics GmbH, Mannheim, Germany), 20 units RiboLock ® RNase inhibitor (Thermo Scientific), 50 units RevertAid ® Premium reverse transcriptase (Thermo Scientific) and 5 µl of RNA. The reaction was incubated at 25 °C for 10 minutes, 50 °C for 60 minutes and 85 °C for 5 minutes.…”

Section: Methodsmentioning

confidence: 99%

Hand-foot-and-mouth disease caused by coxsackievirus A6 in a patient infected with HIV

Mayaphi

Zyl

Sono

et al. 2015

Southern African Journal of Infectious Diseases

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Case studyIn August 2013, a 12-year-old boy infected with human immunodeficiency virus (HIV), who has been on antiretroviral therapy for more than two years, presented to the Tshwane District Hospital HIV clinic with fever and a rash. His symptoms had started two days ago. The rash was mainly on the palms and soles, and was sometimes itchy. His antiretroviral (ARV) drug regimen consisted of zidovudine, lamivudine and nevirapine. He was no longer receiving prophylaxis for pneumocystis pneumonia at the time of consultation.On examination, he was clinically stable and pyrexial (37.6 °C). The boy had a macular rash on his palms and soles (Figure 1), and a vesicular rash at the right corner of his mouth. There were dark streaks on his palate, and no other lesions. In addition to his ARV drugs, he was also prescribed mupirocin ointment and oral acyclovir. A blood sample for syphilis tests was taken on the day of consultation, and a stool sample was submitted a day later for enterovirus testing.Blood taken a month before this consultation revealed that the patient's HIV viral load was undetectable, and the CD4 count was 929 cells/µl (30.9%). The syphilis tests, rapid plasma reagin and the Treponema pallidum haemagglutination assay were all negative. Enterovirus realtime reverse transcription polymerase chain reaction (RT-PCR), carried out on a stool sample, tested positive. A leftover serum sample (after the syphilis testing) tested negative on enterovirus real-time RT-PCR.However, this sample was slightly haemolysed and was tested five days after collection. Nucleotide sequence analysis of the nested enterovirus RT-PCR products from the stool sample showed that the patient was infected with the coxsackievirus A6 (CVA6) strain. At the follow-up visit, the patient and his guardian reported that the rash had disappeared completely without any complications, roughly a week after the consultation. MethodEthical approval for this investigation was obtained from the University A 12-year-old boy on treatment for human immunodeficiency virus (HIV) presented to an HIV clinic with fever and a rash on the palms and soles. The syphilis test were negative. Enterovirus was identified from a stool sample by PCR and characterised as as coxsackievirus A6(CVA6). The patient completely recovered a week later. CVA6 has recently been associated with HFMD. This case highlights the significance of the laboratory confirmation of suspected HFMD cases aand phylogenetic analysis of the identified virus.Peer reviewed.

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Enteric viruses circulating in undiagnosed central nervous system infections at tertiary hospital in São José do Rio Preto, São Paulo, Brazil

Rocha

Estofolete

Milhim

et al. 2020

Journal of Medical Virology

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Enterovirus (EV) is commonly associated with central nervous system (CNS) syndromes. Recently, gastroenteric viruses, including rotavirus (RVA), human astrovirus (HAstV), and norovirus (NoV), have also been associated with CNS neurological disorders. The aim of the present study was to investigate the presence of EV, RVA, HAst, and NoV associated to CNS infections with undiagnosed etiology in Northwest region of São Paulo State, Brazil, and to conduct the molecular characterization of the positive samples detected. A total of 288 cerebrospinal fluid samples collected from July to December 2017 were tested for EV and NoV by quantitative real‐time polymerase chain reaction (RT‐qPCR), HAstV by conventional RT‐PCR, and RVA by enzyme‐linked immunosorbent assay. Positive‐EV samples were inoculated in cells lines, amplified by RT‐PCR and sequenced. RVA, NoV, and HAstV were not detected. EV infection was detected in 5.5% (16/288), and five samples successful genotyped: echovirus 3 (E3) (1/5), coxsackie virus A6 (CVA6) (1/5), and coxsackie virus B4 (CVB4) (3/5). Meningitis was the main syndrome observed (12/16; 75%). CVA6, CVB4, and E3 were identified associated with aseptic meningitis. Reports of CVA6 associated with aseptic meningitis are rare, E3 had not been previously reported in Brazil, and epidemiological data on CVB4 in the country is virtually unknown. The present investigation illustrates the circulation of diverse EV types in a small regional sample set and in a short period of time, highlighting the importance of an active EV surveillance system in CNS infections. Enhanced understanding of undiagnosed CNS infections will assist in public health and health care planning.

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Molecular characterisation of enteroviruses and clinical findings from a cluster of paediatric viral meningitis cases in Tshwane, South Africa 2010–2011

Cited by 12 publications

References 27 publications

Infectious Meningitis

Infectious Meningitis

Hand-foot-and-mouth disease caused by coxsackievirus A6 in a patient infected with HIV

Enteric viruses circulating in undiagnosed central nervous system infections at tertiary hospital in São José do Rio Preto, São Paulo, Brazil

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