Experience in laboratory diagnosis of enterovirus infections in routine medical practice.
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All patients are excreting the virus in urines and in 4 cases in stools. The virus has also been isolated from the blood. These cases focused on the possible role of enteroviruses as causal agents for the glomerulonephritis.
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We report 9 cases of enteroviral infection associated with systemic inflammatory disease (including 4 cases of vasculitis, 1 case of periarteritis nodosa, 1 case of Sharp's syndrome). We then reviewed 36 cases of enteroviral infection with persistent IgM antibodies diagnosed in the virology laboratory in a 6-year period: among them 11 cases were found to present with subacute or chronic inflammatory disease. We conclude that enteroviruses might be important triggers of systemic inflammatory disease.
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Between August and November 1985, 45 patients with suspected aseptic meningitis were investigated using conventional virus isolation procedures and the mu-antibody capture Coxsackie B IgM enzyme-linked immunoabsorbent assay (ELISA) test, which is well known to cross-react with other members of the enterovirus group. An enterovirus was isolated from 22% of patients compared with 67% who were positive in the ELISA test. Not only was the rate of enterovirus detection increased by using this ELISA method, the clinician received a result within 2 days of submission of serum to the laboratory. A positive result was reassuring to the patient and helpful in clinical management. The main disadvantage of this test was its cost since Coxsackie B1-5 virus antigens were essential. Development of a single inexpensive enterovirus-specific antigen is thus desirable.
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