Lymphocytic choriomeningitis virus meningitis after needlestick injury: a case report

• Published in: Antimicrobial resistance & infection control Vol. 8; no. 1; p. 77
• Main Authors: Dräger, Sarah, Marx, Anna-Friederike, Pigny, Fiona, Cherpillod, Pascal, Eisermann, Philip, Sendi, Parham, Widmer, Andreas F
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 20.05.2019; BioMed Central; BMC
• Subjects: Accidental infection; Accidents; Accidents, Occupational; Antibodies; Antibodies, Viral - blood; Arenaviridae Infections - diagnosis; Arenaviridae Infections - etiology; Back pain; Blood tests; Case Report; Case reports; Case studies; Complications and side effects; Diagnosis; Disease control; Disease transmission; Drug resistance; Emergency medical care; Encephalitis; Epidemics; Female; Health aspects; Humans; Illnesses; Immunoglobulin G; Infection; Infections; Laboratories; Laboratory Personnel; Laboratory technicians; Lymphocytic choriomeningitis virus; Lymphocytic choriomeningitis virus - genetics; Magnetic Resonance Imaging; Meningitis; Meningitis - diagnostic imaging; Meningitis - etiology; Meningitis - virology; Nausea; Needlestick injuries; Needlestick Injuries - complications; Needlestick Injuries - virology; Needlestick injury; Penetrating wounds; Risk factors; RT-PCR; Seroconversion; Transplants & implants; Viral infections; Viral meningitis; Virus diseases; Viruses; Work related injuries; Workers; Meningitis; Lymphocytic choriomeningitis virus; Needlestick injury; RT-PCR; Accidental infection
• ISSN: 2047-2994; 2047-2994
• DOI: 10.1186/s13756-019-0524-4

Needlestick accidents while handling of infectious material in research laboratories can lead to life-threatening infections in laboratory personnel. In laboratories working with the lymphocytic choriomeningitis virus (LCMV), the virus can be transmitted to humans through needlestick injury and lead to serious acute illness up to meningitis. We report of a case of LCMV meningitis in a laboratory worker who sustained a penetrating needlestick injury with a LCMV-contaminated hollow needle whilst disposing of a used syringe into the sharps waste bin. Four days after needlestick injury the laboratory worker developed a systemic disease: 11 days after exposure, she was diagnosed with meningitis with clinical signs and symptoms of meningismus, photophobia, nausea and vomiting, requiring hospitalisation. The PCR was positive for LCMV from the blood sample. 18 days after exposure, seroconversion confirmed the diagnosis of LCMV-induced meningitis with an increase in specific LCMV-IgM antibodies to 1:10'240 (day 42: 1:20'480). Ten weeks after exposure, a follow-up titre for IgM returned negative, whereas IgG titre increased to 1:20'480. This is the first case report of a PCR-documented LCMV meningitis, coupled with seroconversion, following needlestick injury. It highlights the importance of infection prevention practices that comprise particularly well established safety precaution protocols in research laboratories handling this pathogenic virus, because exposure to even a small amount of LCMV can lead to a severe, life-threatening infection.