Volume 22, Number 9—September 2016
CME ACTIVITY - Research
Use of Testing for West Nile Virus and Other Arboviruses
Jakapat Vanichanan, Lucrecia Salazar, Susan H. Wootton, Elizabeth Aguilera, Melissa N. Garcia, Kristy O. Murray, and Rodrigo Hasbun
Table 3
Laboratory results, treatment, and outcomes for 751 patients with meningitis and encephalitis, by West Nile virus testing, Houston, Texas, USA
| Variable | West Nile virus testing requested, no. (%), n = 281 | West Nile virus testing not requested, no. (%), n = 470 | p value* |
|---|---|---|---|
| Cerebrospinal fluid profile | |||
| Predominantly lymphocytes† | 218 (78) | 326 (71) | 0.07 |
| Protein >100 mg/dL | 101 (36) | 137 (29) | 0.12 |
| Glucose <45 mg/dL |
27 (10) |
79 (17) |
0.005 |
| Cerebrospinal fluid microbiological testing | |||
| Bacteria, culture | 272 (96) | 447 (95) | 0.35 |
| Mycobacteria, culture or PCR | 102 (36) | 89 (19) | <0.001 |
| Fungi, culture or antigen assay | 91 (32) | 71 (15) | <0.001 |
| Herpes simplex virus, PCR | 174 (62) | 157 (33) | <0.001 |
| Enterovirus, reverse transcription PCR |
104 (37) |
139 (30) |
0.03 |
| Magnetic resonance imaging of brain |
139 (49) |
151 (32) |
<0.001 |
| Management and outcomes | |||
| Hospitalization | 276 (98) | 449 (96) | 0.06 |
| Empirical antibiotic treatment | 215 (77) | 367 (78) | 0.65 |
| Empirical antiviral treatment | 98 (35) | 95 (20) | <0.001 |
| Adverse outcome‡ |
51 (18) |
34 (7) |
<0.001 |
| Etiology | |||
| Unknown | 206 (73) | 312 (66) | 0.051 |
| Viral | 46 (16) | 114 (24) | 0.017 |
| Bacterial | 16 (6) | 27 (6) | 1.00 |
| Fungal | 6 (2) | 9 (2) | 0.80 |
| Mycobacterial | 5 (1) | 3 (1) | 0.43 |
| Noninfectious | 2 (1) | 5 (1) | 1.00 |
*p<0.001 after Bonferroni correction considered statistically significant.
†Median leuckocytes, cells/mL (range) 134 (1–4275) for samples tested and 143 (0–49000) for samples not tested for West Nile virus; p = 0.017.
‡Glasgow Outcome Scale score 1–4 (14).
Page created: August 10, 2016
Page updated: August 16, 2016
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