Aseptic meningitis caused by Leptospira spp diagnosed by polymerase chain reaction
Leptospirosis is a zoonotic disease caused by the pathogenic Leptospira spp. The clinical presentations are diverse, ranging from undifferentiated fever to fulminant disease including meningeal forms. The neurological leptospirosis forms are usually neglected. The aim of this study was to investigat...
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Published in | Memórias do Instituto Oswaldo Cruz Vol. 105; no. 8 |
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Main Authors | , , |
Format | Journal Article |
Published |
Brazil
Fundação Oswaldo Cruz, Fiocruz
21.03.2011
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Subjects | |
Online Access | Get full text |
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Summary: | Leptospirosis is a zoonotic disease caused by the pathogenic Leptospira
spp. The clinical presentations are diverse, ranging from
undifferentiated fever to fulminant disease including meningeal forms.
The neurological leptospirosis forms are usually neglected. The aim of
this study was to investigate leptospirosis as the cause of aseptic
meningitis using different diagnostic techniques including the
polymerase chain reaction (PCR). Thirty-nine cerebrospinal fluid (CSF)
samples from patients presenting with meningeal abnormalities,
predominance of lymphocytes and negative results by traditional
microbiological tests were processed by leptospiral culture,
anti-leptospiral antibody response and PCR. Leptospira spp DNA was
detected in 23 (58.97%) of the CSF samples. Anti-leptospiral antibodies
were found in 13 (33.33%) CSF samples. Twelve CSF samples were positive
by PCR assay and negative by microscopic agglutination test (MAT)
assay. Two CSF samples were positive by MAT and negative by PCR. The
positive and negative agreement between both tests was 11 and 14,
respectively. CSF samples from six cases of unknown diagnosis were
positive by PCR assay. Eight cases showed positive results using PCR
and MAT. Leptospirosis could be detected by PCR assay from the 3rd-26th
day after illness onset. The sensitivity of the PCR was assessed with
confirmed cases of leptospirosis (by MAT) and found to be 89.5%. All
CSFs were negative by culture. PCR was found to be a powerful tool for
diagnosing meningitis cases of leptospirosis. We recommend that it may
be used as a supplementary diagnostic tool, especially in the early
stages of the disease, when other diagnostic techniques such as
serology are not sensitive. |
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ISSN: | 1678-8060 1678-8060 |