ePresentation Sessions

Abstract

Background and aims: Viral meningitis or encephalitis can be caused by various viruses. However, in about half of the patients with a clinical diagnosis of viral meningitis or encephalitis no pathogen is found during routine diagnostic work-up. With this study we aimed to validate a method to identify viruses, based on the cDNA amplified restriction fragment-length polymorphism technique (cDNA-AFLP), in cerebrospinal fluid (CSF) of patients with viral meningitis or encephalitis with and without identified causative pathogens. Methods: Adult patients with a diagnosis of viral meningitis or encephalitis (based on clinical and/or laboratory results) were prospectively included. A selected panel of the most common causative viruses was tested in the CSF of these patients with quantitative polymerase chain reaction (qPCR). CSF specimens of all patients were then tested using the Virus-Discovery-cDNA-AFLP method, combined with Ion Torrent next generation sequencing (VIDISCANGS). Results from qPCR tests and VIDISCA-NGS were evaluated. Results: From 2012 to 2015 we included 38 patients with viral meningitis or encephalitis. In 23 patients (60%) a causative pathogen was identified by qPCR. In ten of these patients the identified virus was also found by VIDISCANGS. In fifteen patients (40%) no virus could be identified by qPCR. In one of these patients, an enterovirus was discovered by VIDISCA-NGS. Conclusion: In patients with a clinical diagnosis of viral meningitis or encephalitis but no identified causative virus by PCR in CSF, VIDISCA-NGS could be of additional diagnostic value. Studies in larger patient populations with suspected viral meningitis or encephalitis are necessary to determine diagnostic accuracy of VIDISCA-NGS in CSF.