The utility of CSF PCR in central nervous system Varicella zoster infection in HIV

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dc.contributor.advisorBryer, Alanen_ZA
dc.contributor.advisorBateman, Kathleenen_ZA
dc.contributor.authorStanley, Alan Michaelen_ZA
dc.date.accessioned2016-02-05T07:19:18Z
dc.date.available2016-02-05T07:19:18Z
dc.date.issued2015en_ZA
dc.descriptionIncludes bibliographical referencesen_ZA
dc.description.abstractAims: To assess the clinical and cerebrospinal fluid characteristics, and the role of tuberculous meningitis (TBM) as a confounder, in a cohort of HIV positive individuals with positive varicella zoster virus (VZV) positive cerebrospinal fluid PCR. Methods: Patients in the NHLS database at Groote Schuur Hospital with positive CSF VZV PCR who were also HIV co-infected and whose folders were available for clinical review were reviewed. Clinical and biochemical data were collected. Patients were divided into two groups based an accepted case definition for TBM. Differences between groups were assessed using Mann-Whitney U or Chi squared tests as appropriate. Results: There were 437 for VZV PCR over three years. Of these 98 were positive and, after exclusions, 31 HIV positive patients were included for further analysis. Median age was 31 and median CD4 count was 146 cells/mm³. 11 (35%) had meningitis and 8 (25%) had encephalitis. 13 (42%) met the case definition for TBM. Patients with CNS varicella were frequently confused whereas those with TBM presented sub-acutely. There were no differences in CSF characteristics. Additional organisms were detected 6 (19%) patients. 4 (13%) patients died in hospital. CSF TB culture was requested in 24 (77%) patients and extra CNS samples were sent in only 4 patients. Conclusion: The clinical and CSF presentation of CNS Varicella and TBM overlap and in this cohort patients were under investigated for TB. In settings of high TB prevalence the possibility of false positive PCR or incidental varicella reactivation should be considered.en_ZA
dc.identifier.apacitationStanley, A. M. (2015). <i>The utility of CSF PCR in central nervous system Varicella zoster infection in HIV</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Division of Urology. Retrieved from http://hdl.handle.net/11427/16778en_ZA
dc.identifier.chicagocitationStanley, Alan Michael. <i>"The utility of CSF PCR in central nervous system Varicella zoster infection in HIV."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Division of Urology, 2015. http://hdl.handle.net/11427/16778en_ZA
dc.identifier.citationStanley, A. 2015. The utility of CSF PCR in central nervous system Varicella zoster infection in HIV. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Stanley, Alan Michael AB - Aims: To assess the clinical and cerebrospinal fluid characteristics, and the role of tuberculous meningitis (TBM) as a confounder, in a cohort of HIV positive individuals with positive varicella zoster virus (VZV) positive cerebrospinal fluid PCR. Methods: Patients in the NHLS database at Groote Schuur Hospital with positive CSF VZV PCR who were also HIV co-infected and whose folders were available for clinical review were reviewed. Clinical and biochemical data were collected. Patients were divided into two groups based an accepted case definition for TBM. Differences between groups were assessed using Mann-Whitney U or Chi squared tests as appropriate. Results: There were 437 for VZV PCR over three years. Of these 98 were positive and, after exclusions, 31 HIV positive patients were included for further analysis. Median age was 31 and median CD4 count was 146 cells/mm³. 11 (35%) had meningitis and 8 (25%) had encephalitis. 13 (42%) met the case definition for TBM. Patients with CNS varicella were frequently confused whereas those with TBM presented sub-acutely. There were no differences in CSF characteristics. Additional organisms were detected 6 (19%) patients. 4 (13%) patients died in hospital. CSF TB culture was requested in 24 (77%) patients and extra CNS samples were sent in only 4 patients. Conclusion: The clinical and CSF presentation of CNS Varicella and TBM overlap and in this cohort patients were under investigated for TB. In settings of high TB prevalence the possibility of false positive PCR or incidental varicella reactivation should be considered. DA - 2015 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - The utility of CSF PCR in central nervous system Varicella zoster infection in HIV TI - The utility of CSF PCR in central nervous system Varicella zoster infection in HIV UR - http://hdl.handle.net/11427/16778 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16778
dc.identifier.vancouvercitationStanley AM. The utility of CSF PCR in central nervous system Varicella zoster infection in HIV. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Division of Urology, 2015 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/16778en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDivision of Urologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherNeurologyen_ZA
dc.subject.otherHIV Infectionsen_ZA
dc.subject.otherMeningitisen_ZA
dc.subject.otherTuberculosisen_ZA
dc.titleThe utility of CSF PCR in central nervous system Varicella zoster infection in HIVen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMeden_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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