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July 28, 1978

Simultaneous Serum and CSF Antibodies in Herpes Simplex Virus Encephalitis

Author Affiliations

From the Hutzel Hospital Medical Unit, Department of Medicine, Wayne State University School of Medicine, Detroit.

JAMA. 1978;240(4):356-360. doi:10.1001/jama.1978.03290040034018

Serial concomitant paired sera (S) and CSF were taken from eight patients with biopsy-proved herpes simplex virus encephalitis (HSVE). These specimen pairs were compared with 28 others from patients with various neurologic conditions. Before and after reduction with 2-mercaptoethanol, a ratio of S/CSF antibody titers of ≤20 with either the passive hemagglutinating (PHA) or immune adherence hemagglutinating (IAHA) antibody tests occurred in every patient with HSVE. Diagnostic S/CSF ratios were noted in three patients before biopsy of the brain and in four patients by the tenth day of neurologic disease. Among control subjects, a ratio of S/CSF titers >20 was observed in all but four patients. Each of the latter patients had neurologic diagnoses easily distinguishable from HSVE. The PHA or IAHA S/CSF ratio offers a rapid, reliable method for the diagnosis of HSVE (P<.001).

(JAMA 240:356-360, 1978)