Abstract:
Lymphocytic choriomeningitis virus (LCMV) is a neglected rodent-borne arenavirus, primarily spread by common house mouse species. Acquired human infections range from asymptomatic to mild flu-like symptoms and self-resolving neurological diseases. In contrast, intrauterine LCMV infection is associated with high mortality and morbidity. Infection of the fetus often leads to fetal death, and surviving fetuses may develop vision impairment and central nervous system developmental disorders. LCMV is mainly diagnosed by serological methods using in-house indirect immunofluorescence assays. LCMV nucleic acid is detected by the nested RT-PCR method and confirmed by Sanger sequencing. In Hungary, 23 acquired lymphocytic choriomeningitis cases were diagnosed between 2017 and 2023. Ten out of 23 confirmed patients proved to be positive by the PCR method. Two cases of intrauterine LCMV infections were detected in 2019 and 2021, respectively. The IgG antibody titers measured in the infant\'s serum samples were much higher than the IgG titers of the maternal serum samples. Both IgM and IgA antibodies were detectable in the infants\' sera. As the microbiological diagnosis of LCMV is rather challenging and the symptoms are very similar to the clinical picture of other common teratogenic pathogens such as cytomegalovirus or Toxoplasma gondii, intrauterine LCMV infections might still be underdiagnosed.
摘要:
淋巴细胞脉络膜脑膜炎病毒(LCMV)是一种被忽视的啮齿动物传播的沙粒病毒,主要由普通家鼠物种传播。人类获得性感染范围从无症状到轻度流感样症状和自我解决的神经系统疾病。相比之下,宫内LCMV感染与高死亡率和高发病率相关。胎儿感染常导致胎儿死亡,存活的胎儿可能会出现视力障碍和中枢神经系统发育障碍。LCMV主要通过血清学方法使用内部间接免疫荧光测定来诊断。LCMV核酸通过巢式RT-PCR方法检测并通过Sanger测序确认。在匈牙利,在2017年至2023年之间诊断出23例获得性淋巴细胞脉络膜脑膜炎病例。通过PCR方法证明23名确诊患者中有10名阳性。2019年和2021年分别检测到2例宫内LCMV感染。在婴儿血清样品中测量的IgG抗体滴度远高于母体血清样品的IgG滴度。在婴儿血清中均可检测到IgM和IgA抗体。由于LCMV的微生物学诊断相当具有挑战性,症状与其他常见致畸病原体如巨细胞病毒或弓形虫的临床表现非常相似,宫内LCMV感染可能仍未被诊断。