Rapid Diagnosis of Enterovirus Meningitis by Immunofluorescent Staining of CSF Leukocytes

Abstract

Indirect immunofluorescence was applied to achieve the rapid diagnosis of enteroviral meningitis within hours of receipt of the specimen. Cerebrospinal fluid (CSF) leukocytes from 40 patients were studied by a method adapted to utilize combination antiserum pools in conjunction with indirect immunofluorescence, and results were compared to those of conventional isolation and serological techniques. When virus was isolated from the CSF (17 patients), there was general agreement with the virus identified by immunofluorescence staining of CSF leukocytes. The advantages of immunofluorescence were particularly striking in 19 patients from whom virus could not be isolated from the CSF and in 4 patients from whom virus could not even be isolated from the throat or rectum. By immunofluorescence, virus was detected in 20 of 21 of these patients. Overall, the rapid immunofluorescence findings were confirmed by the slower conventional methods in 32 of 33 cases. Economy of both time and materials was made practicable by use of the LBM combination antiserum pools, which allow 42 antigenic types to be identified in a single set of 8 simultaneous tests.

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

“…However, in many parts of the world where domestic dogs are not vaccinated routinely, rabies remains a feared disease (151 (145), with detection and identification of the infecting enterovirus in 36 of 40 specimens within 2 h. By this method, the virus can be identified on days 6 through 10 of infection, when growth in cell culture is no longer possible. The disadvantages of the method are the need for maintaining a large number of antisera, the low sensitivity of the reagents under the required dilutions, and, in some samples, the lack of a sufficient number of leukocytes in the CSF for measurement (145). In addition, frequent nonspecific fluorescence of CSF lymphocytes has been reported by subsequent workers (52).…”

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

“…Immunofluorescent (IF) staining of CSF leukocytes during enteroviral meningitis has been demonstrated (145), with detection and identification of the infecting enterovirus in 36 of 40 specimens within 2 h. By this method, the virus can be identified on days 6 through 10 of infection, when growth in cell culture is no longer possible. The disadvantages of the method are the need for maintaining a large number of antisera, the low sensitivity of the reagents under the required dilutions, and, in some samples, the lack of a sufficient number of leukocytes in the CSF for measurement (145). In addition, frequent nonspecific fluorescence of CSF lymphocytes has been reported by subsequent workers (52).…”

Rapid Immunofluorescence Diagnosis of Acute Hemorrhagic Conjunctivitis Caused by Enterovirus 70

“…Our findings suggest that the IF technique can be applied for rapid diagnosis of AHC infection. Such a procedure has been shown to be practical for detecting enterovirus-infected cells in spinal fluid and for rapid typing of enteroviruses [8,9],…”