Sunday, April 04, 2010

Pearls CSF and alternate forms of meningitis: PCR for TB, CMV,enterovirus, VZV, toxo meningitis

1.  In CSF , PCR has sens/spec of 98 and 94 % respectively, and stay positive for a long time in one third.
2. In cases of false negative, treat with acyclovir anyway for ten days if clinical suspicion is high and consider repeating LP at 48 hours.

1.   PCR is 79 % sensitive, 95 % specific

1  PCR in CSF is 42 % sensitive, 100 % specific

1.  more sensitive than viral culture

mycoplasma pn
1.need to check IgM and IgM is CSF: serum

1.  Antibody is positive at tn days in half
immunocompetent-- initially test with PCR for HSVE, VZV, and enterovirus
immunocompromised -- add  EBV and CMV PCR and HHV6 and HHV7
Consider quantitative CSF: blood esp HIV patients

No comments: