Detection of virus-specific T cells via ELISpot corroborates early diagnosis in human Borna disease virus 1 (BoDV-1) encephalitis.
Borna disease virus 1 (BoDV-1)
ELISpot
Encephalitis
Indirect immune fluorescence assay (iIFA)
Zoonosis
Journal
Infection
ISSN: 1439-0973
Titre abrégé: Infection
Pays: Germany
ID NLM: 0365307
Informations de publication
Date de publication:
12 Apr 2024
12 Apr 2024
Historique:
received:
21
02
2024
accepted:
21
03
2024
medline:
12
4
2024
pubmed:
12
4
2024
entrez:
12
4
2024
Statut:
aheadofprint
Résumé
Within endemic regions in southern and eastern Germany, Borna disease virus 1 (BoDV-1) causes rare zoonotic spill-over infections in humans, leading to encephalitis with a high case-fatality risk. So far, intra-vitam diagnosis has mainly been based on RT-qPCR from cerebrospinal fluid (CSF) and serology, both being associated with diagnostic challenges. Whilst low RNA copy numbers in CSF limit the sensitivity of RT-qPCR from this material, seroconversion often occurs late during the course of the disease. Here, we report the new case of a 40 - 50 year-old patient in whom the detection of virus-specific T cells via ELISpot corroborated the diagnosis of BoDV-1 infection. The patient showed a typical course of the disease with prodromal symptoms like fever and headaches 2.5 weeks prior to hospital admission, required mechanical ventilation from day three after hospitalisation and remained in deep coma until death ten days after admission. Infection was first detected by positive RT-qPCR from a CSF sample drawn four days after admission (viral load 890 copies/mL). A positive ELISpot result was obtained from peripheral blood collected on day seven, when virus-specific IgG antibodies were not detectable in serum, possibly due to previous immune adsorption for suspected autoimmune-mediated encephalitis. This case demonstrates that BoDV-1 ELISpot serves as additional diagnostic tool even in the first week after hospitalisation of patients with BoDV-1 encephalitis.
Sections du résumé
BACKGROUND
BACKGROUND
Within endemic regions in southern and eastern Germany, Borna disease virus 1 (BoDV-1) causes rare zoonotic spill-over infections in humans, leading to encephalitis with a high case-fatality risk. So far, intra-vitam diagnosis has mainly been based on RT-qPCR from cerebrospinal fluid (CSF) and serology, both being associated with diagnostic challenges. Whilst low RNA copy numbers in CSF limit the sensitivity of RT-qPCR from this material, seroconversion often occurs late during the course of the disease.
CASE PRESENTATION
METHODS
Here, we report the new case of a 40 - 50 year-old patient in whom the detection of virus-specific T cells via ELISpot corroborated the diagnosis of BoDV-1 infection. The patient showed a typical course of the disease with prodromal symptoms like fever and headaches 2.5 weeks prior to hospital admission, required mechanical ventilation from day three after hospitalisation and remained in deep coma until death ten days after admission.
RESULTS
RESULTS
Infection was first detected by positive RT-qPCR from a CSF sample drawn four days after admission (viral load 890 copies/mL). A positive ELISpot result was obtained from peripheral blood collected on day seven, when virus-specific IgG antibodies were not detectable in serum, possibly due to previous immune adsorption for suspected autoimmune-mediated encephalitis.
CONCLUSION
CONCLUSIONS
This case demonstrates that BoDV-1 ELISpot serves as additional diagnostic tool even in the first week after hospitalisation of patients with BoDV-1 encephalitis.
Identifiants
pubmed: 38607591
doi: 10.1007/s15010-024-02246-5
pii: 10.1007/s15010-024-02246-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : University Hospital Regensburg, Germany
ID : ReForM-A program
Organisme : German Federal Ministry of Education and Research
ID : 01KI2002
Organisme : German Federal Ministry of Education and Research
ID : 01KI2005F
Organisme : Bavarian State Ministry of Health and Care
ID : Bornavirus - Focal Point Bavaria 2.0
Organisme : Bavarian State Ministry of Health and Care
ID : Bornavirus - Focal Point Bavaria 2.0
Organisme : German Ministry of Education and Research
ID : PREPMedVet no. 13N15449
Informations de copyright
© 2024. The Author(s).
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