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Clinical Trial
. 2018 Nov 16;13(11):e0207440.
doi: 10.1371/journal.pone.0207440. eCollection 2018.

Detection of central nervous system viral infections in adults in Manado, North Sulawesi, Indonesia

Arthur H P Mawuntu  1 , Janno B B Bernadus  1 , Rama Dhenni  2 , Ageng Wiyatno  2 , Riane Anggreani  1 , Feliana  1 , Frilasita A Yudhaputri  2 , Ungke Anton Jaya  3 , Chairin Nisa Ma'roef  2 , Aghnianditya K Dewantari  2 , Araniy Fadhilah  2 , Jeremy P Ledermann  4 , Ann M Powers  4 , Dodi Safari  2 , Khin Saw Aye Myint  2
Affiliations
Clinical Trial

Detection of central nervous system viral infections in adults in Manado, North Sulawesi, Indonesia

Arthur H P Mawuntu et al. PLoS One. .

Abstract

Central nervous system (CNS) viral infections are important causes of morbidity and mortality worldwide but the systematic survey of patients admitted to hospitals with CNS infections in many countries, including Indonesia, is limited. To obtain more information regarding the causes of CNS infections in Indonesia, this study was performed to detect and identify viral agents associated with CNS infections amongst in-patients at a referral hospital in Manado, North Sulawesi, Indonesia. Adult patients admitted to R.D. Kandou General Hospital with presumed CNS infection were enrolled. Cerebrospinal fluid, serum, and throat swab samples were collected and tested using molecular, serological, and virus isolation assays. A confirmed viral etiology was established in three and a probable/possible in 11 out of 74 patients. The most common was herpes simplex virus 1 (7/74, 9.5%), followed by Epstein-Barr virus (2/74, 2.7%), cytomegalovirus (1/74, 1.4%), enterovirus D68 (1/74, 1.4%), rhinovirus A (1/74, 1.4%), dengue virus (1/64, 1.6%), and Japanese encephalitis virus (1/64, 1.6%). There were 20 fatal cases (27.0%) during hospitalization in which eight were associated with viral causes. We identified herpes simplex virus 1 as the most common cause of CNS infection among adults in North Sulawesi with most of the cases remaining undiagnosed. Our study highlights the challenges in establishing the etiology of viral CNS infections and the importance of using a wide range of molecular and serological detection methods to identify CNS viruses.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram for total enrolled cases, collected samples available, and assays performed for different sample types in the study.
See this image and copyright information in PMC

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