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False Positive PCR for Herpes Simplex Virus (HSV) in Childhood CNS Infections

Iranian Red Crescent Medical Journal
Kowsar Medical Institute
Publication Date
  • Editorial
  • Medicine


The relative impact of smoking or Hypertension on severity of premature coronary artery disease Iranian Red Crescent Medical Journal Iran Red Crescent Med J 2012; 14(4):197 ©Iranian Red Crescent Medical Journal EDITORIAL False Positive PCR for Herpes Simplex Virus (HSV) in Childhood CNS Infections In 2010; 12(5):568-571 issue of IRCMJ journal, an article about herpetic encephalitis (HE) in children was published with the following title: Clinical Ma- nifestations, Laboratory Findings and Outcomes of Children with Herpetic Encephalitis in Amirkola Children Hospital, Northern Iran. The authors found that during 2 years 34% (17 cas- es) of the 50 patients with clinical diagnosis of ence- phalitis had positive PCR for HSV, only 28% of their HE cases had altered consciousness but they did not say anything about focal neurologic signs and they did not have any disability or mortality and all of the pa- tients were discharged in good general condition. I think that there has been a technical problem with HSV PCR in this research because the incidence of HE was unacceptably high and the prognosis was unbelievably good. Their cases must have been cases of viral meningitis with false positive HSV PCR probably due to contamination. The annual incidence of HE in the whole popula- tion was between one in 460000 to 2.2 per million population per year and one-third of all cases oc- curred in children and adolescents.1-3 Amirkola Child- ren Hospital needs to cover between 4250000 to 18700000 children each year to have such a high number of HE, while we know that the whole popula- tion of the Province of Mazandaran (which Babol is the center of it) is around 3000000 and 21.3% of the population are younger than 14 years. Over 90 per- cent of HSV encephalitis cases have one of the al- tered mentation and level of consciousness, focal cranial nerve deficits, hemiparesis, dysphasia, apha- sia, ataxia, or focal seizures.1 Even with appropriate diagnosis and tre

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