Skip to main content

Table 8 Spectrum of viral pathogens and diagnostic methods

From: S1 guidelines “lumbar puncture and cerebrospinal fluid analysis” (abridged and translated version)

PathogenDiagnostic method (1st choice)MaterialDiagnostic method (2nd Choice)MaterialReference
Immunocompetent patients
 Enterovirus (Echo, Coxsackie A/B)RT-PCR
Sensitivity 97% Specificity 100%
CSF
Stool, rhinopharyngeal swab
Direct detection by electron microscopyStool[18, 198]
 Flavivirus (FSME)Serology
Sensitivity 99%
Specificity 98%
BloodRT-PCR (early Phase)
AI after 10-14 days
CSF[72]
 Herpes simplex virus
Type 1 & 2
DNA-PCR
Sensitivity > 95%
Specificity 100%
CSFAI after 10-14 daysCSF[63]
 Varicella zoster virusDNA-PCR
Sensitivity 95%
Specificity 100%
CSFAI after 10-14 daysCSF[104]
Immunocompromised patients
 Cytomegaly virusDNA-PCR
Sensitivity 99%
Specificity 99%
CSFAI after 10-14 days
pp65-Antigen
CSF
Blood/ CSF
[4, 19, 96]
 Epstein-Barr virusDNA-PCR
Sensitivity 100%
Specificity 100%
CSFAI after 10-14 daysCSF[80]
 Human immune deficiency virusSerology
RT-PCR
Sensitivity 99%
Specificity 100%
BloodAI after 10-14 daysCSF[5]
 John Cunningham virusDNA-PCR
Sensitivity 95%
Specificity > 90%
CSFAI after 10-14 daysCSF[20]
Other viral CNS infections
 Adeno virusDNA-PCR
Sensitivity 100%
Specificity 99%
CSFAntigen detectionCSF[28]
 Hanta virusDNA-PCR
Sensitivity 95%
Specificity 100%
CSFAI after 10-14 daysCSF[178]
 MeaslesSerology
RT-PCR
Sensitivity 100%
Specificity 100%
Serum
CSF
AI after 10-14 daysCSF[2]
 Mumps virusSerology
RT-PCR
Sensitivity 90%
Specificity 100%
Serum
CSF
AI after 10-14 days
pp65-Antigen
CSF
Blood/ CSF
[148]
 Polio virusSerology
RT-PCR
Sensitivity 100%
Specificity 100%
CSFAI after 10-14 daysCSF[69]
 Rabies virusRT-PCR
Sensitivity 99%
Specificity 99%
CSF
Blood
Saliva
Direct detection by electron microscopyCSF Saliva
Brain
[47]
 Rubella virusSerology
RT-PCR
Sensitivity 79%
Specificity 100%
Serum
CSF
AI after 10-14 daysCSF[131]
 Zika virusSerology
RT-PCR
Sensitivity 91%
Specificity 97%
Serum
CSF / Urine
AI after 10-14 daysCSF[168]