Japanese encephalitis laboratory findings: Difference between revisions
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{{Japanese encephalitis}} | {{Japanese encephalitis}} | ||
{{CMG}} | {{CMG}}; {{AE}} {{AG}} | ||
==Overview== | ==Overview== | ||
The diagnostic method of choice for Japanese encephalitis is laboratory testing. Laboratory findings consistent with the diagnosis of Japanese encephalitis include detection of [[IgM]] antibodies in [[serum]] and [[cerebrospinal fluid]], moderate [[leukocytosis]], mild [[anemia]], and [[hyponatremia]]. [[Cerebrospinal fluid]] typically has a mild to moderate [[pleocytosis]] with a [[lymphocytic]] predominance, slightly elevated [[protein]], and normal ratio to [[plasma glucose]]. Because humans have low or undetectable levels of [[viremia]] by the time distinctive clinical symptoms are recognized, virus isolation and [[nucleic acid]] amplification tests are insensitive and should not be used for ruling out a diagnosis of Japanese encephalitis. | |||
==Laboratory Findings== | ==Laboratory Findings== | ||
Laboratory diagnosis of | The diagnostic method of choice for Japanese encephalitis is laboratory testing. Laboratory findings consistent with the diagnosis of Japanese encephalitis include detection of [[IgM]] antibodies in [[serum]] and [[cerebrospinal fluid]], moderate [[leukocytosis]], mild [[anemia]], and [[hyponatremia]]. Japanese encephalitis virus IgM antibodies are usually detectable 3 to 8 days after onset of illness and persist for 30 to 90 days. Therefore, positive IgM antibodies occasionally may reflect a past [[infection]] or [[vaccination]]. Serum collected within 10 days of illness onset may not have detectable IgM, and the test should be repeated on a [[convalescent]] sample.<ref name=CDCJaEnceph3> Japanese Encephalitis Diagnostic Testing. Centers for Disease Control and Prevention (CDC), National Center for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases. (2015) http://www.cdc.gov/japaneseencephalitis/healthcareproviders/healthcareproviders-diagnostic.html Accessed on April 19, 2016. </ref><ref name="pmid24008230">{{cite journal| author=Doti P, Castro P, Martínez MJ, Zboromyrska Y, Aldasoro E, Inciarte A et al.| title=A case of Japanese encephalitis in a 20 year-old Spanish sportsman, February 2013. | journal=Euro Surveill | year= 2013 | volume= 18 | issue= 35 | pages= 20573 | pmid=24008230 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24008230 }} </ref> | ||
Other cerebrospinal fluid ( | Other [[cerebrospinal fluid]] findings include:<ref name="pmid16406800">{{cite journal| author=Ravi V, Desai A, Balaji M, Apte MP, Lakshman L, Subbakrishna DK et al.| title=Development and evaluation of a rapid IgM capture ELISA (JEV-Chex) for the diagnosis of Japanese encephalitis. | journal=J Clin Virol | year= 2006 | volume= 35 | issue= 4 | pages= 429-34 | pmid=16406800 | doi=10.1016/j.jcv.2005.11.004 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16406800 }} </ref><ref name="pmid2987367">{{cite journal| author=Burke DS, Nisalak A, Ussery MA, Laorakpongse T, Chantavibul S| title=Kinetics of IgM and IgG responses to Japanese encephalitis virus in human serum and cerebrospinal fluid. | journal=J Infect Dis | year= 1985 | volume= 151 | issue= 6 | pages= 1093-9 | pmid=2987367 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2987367 }} </ref> | ||
*Mild to moderate [[pleocytosis]] with a [[lymphocytic]] predominance | *Mild to moderate [[pleocytosis]] with a [[lymphocytic]] predominance | ||
*Slightly elevated [[protein]] | *Slightly elevated [[protein]] | ||
*Normal ratio of CSF to [[plasma glucose]] | *Normal ratio of CSF to [[plasma glucose]] | ||
Other laboratory findings include: | Other laboratory findings include: | ||
*[[Leukocytosis]] | *[[Leukocytosis]] | ||
*Mild [[anemia]] | *Mild [[anemia]] | ||
*[[Hyponatremia]] | *[[Hyponatremia]] | ||
For patients with | For patients with Japanese encephalitis virus IgM antibodies, confirmatory [[neutralisation (immunology)|neutralizing]] [[antibody]] testing should be performed. In fatal cases, [[nucleic acid]] amplification, [[histopathology]] with [[immunohistochemistry]], and virus culture of [[autopsy]] tissues may be useful. Diagnostic testing for Japanese encephalitis virus IgM antibodies is commercially available. Confirmatory testing is available at the [[CDC]] and specialized reference laboratories.<ref name=CDCJaEnceph3> Japanese Encephalitis Diagnostic Testing. Centers for Disease Control and Prevention (CDC), National Center for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases. (2015) http://www.cdc.gov/japaneseencephalitis/healthcareproviders/healthcareproviders-diagnostic.html Accessed on April 19, 2016. </ref> | ||
==References== | |||
{{Reflist|2}} | |||
[[Category:FinalQCRequired]] | |||
[[Category:Neurology]] | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 18:06, 18 September 2017
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Japanese encephalitis laboratory findings On the Web |
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Risk calculators and risk factors for Japanese encephalitis laboratory findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anthony Gallo, B.S. [2]
Overview
The diagnostic method of choice for Japanese encephalitis is laboratory testing. Laboratory findings consistent with the diagnosis of Japanese encephalitis include detection of IgM antibodies in serum and cerebrospinal fluid, moderate leukocytosis, mild anemia, and hyponatremia. Cerebrospinal fluid typically has a mild to moderate pleocytosis with a lymphocytic predominance, slightly elevated protein, and normal ratio to plasma glucose. Because humans have low or undetectable levels of viremia by the time distinctive clinical symptoms are recognized, virus isolation and nucleic acid amplification tests are insensitive and should not be used for ruling out a diagnosis of Japanese encephalitis.
Laboratory Findings
The diagnostic method of choice for Japanese encephalitis is laboratory testing. Laboratory findings consistent with the diagnosis of Japanese encephalitis include detection of IgM antibodies in serum and cerebrospinal fluid, moderate leukocytosis, mild anemia, and hyponatremia. Japanese encephalitis virus IgM antibodies are usually detectable 3 to 8 days after onset of illness and persist for 30 to 90 days. Therefore, positive IgM antibodies occasionally may reflect a past infection or vaccination. Serum collected within 10 days of illness onset may not have detectable IgM, and the test should be repeated on a convalescent sample.[1][2]
Other cerebrospinal fluid findings include:[3][4]
- Mild to moderate pleocytosis with a lymphocytic predominance
- Slightly elevated protein
- Normal ratio of CSF to plasma glucose
Other laboratory findings include:
For patients with Japanese encephalitis virus IgM antibodies, confirmatory neutralizing antibody testing should be performed. In fatal cases, nucleic acid amplification, histopathology with immunohistochemistry, and virus culture of autopsy tissues may be useful. Diagnostic testing for Japanese encephalitis virus IgM antibodies is commercially available. Confirmatory testing is available at the CDC and specialized reference laboratories.[1]
References
- ↑ 1.0 1.1 Japanese Encephalitis Diagnostic Testing. Centers for Disease Control and Prevention (CDC), National Center for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases. (2015) http://www.cdc.gov/japaneseencephalitis/healthcareproviders/healthcareproviders-diagnostic.html Accessed on April 19, 2016.
- ↑ Doti P, Castro P, Martínez MJ, Zboromyrska Y, Aldasoro E, Inciarte A; et al. (2013). "A case of Japanese encephalitis in a 20 year-old Spanish sportsman, February 2013". Euro Surveill. 18 (35): 20573. PMID 24008230.
- ↑ Ravi V, Desai A, Balaji M, Apte MP, Lakshman L, Subbakrishna DK; et al. (2006). "Development and evaluation of a rapid IgM capture ELISA (JEV-Chex) for the diagnosis of Japanese encephalitis". J Clin Virol. 35 (4): 429–34. doi:10.1016/j.jcv.2005.11.004. PMID 16406800.
- ↑ Burke DS, Nisalak A, Ussery MA, Laorakpongse T, Chantavibul S (1985). "Kinetics of IgM and IgG responses to Japanese encephalitis virus in human serum and cerebrospinal fluid". J Infect Dis. 151 (6): 1093–9. PMID 2987367.