Laboratory Studies

Lymphocytic choriomeningitis virus (LCMV) infection is initially diagnosed based on a suggestive history that is confirmed by various laboratory investigations.^[9]

Complete blood cell (CBC) count may reveal leukopenia and thrombocytopenia early in the course of illness.

The preferred diagnostic modality is assessment of acute and convalescent immunoglobulin M (IgM) and immunoglobulin G (IgG) titers from both the serum and cerebrospinal fluid (CSF). The sensitivity of enzyme-linked immunosorbent assay (ELISA) is greater than that of immunofluorescence (IFA)–based assays. Complement fixation is insensitive and should not be used.^[15]

Immunohistochemical staining, virus culture, and reverse transcription-polymerase chain reaction (RT-PCR) of tissues may be useful.

Typical findings of lumbar puncture are as follows:^[9]

Elevated opening pressure, occasionally with papilledema
Protein concentration from 50-300 mg/dL (can exceed 600 mg/dL) ^[11]
Lymphocytic pleocytosis with several hundred cells/µL (range, 10 to >3000 cells/µL)
Hypoglycorrhachia (in fewer than one third of patients)

Treatment & Management

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Author

Philip J McDonald, MD Fellow, Division of Infectious Diseases, Department of Internal Medicine, Detroit Medical Center, Wayne State University School of Medicine

Philip J McDonald, MD is a member of the following medical societies: American College of Physicians, American Medical Association, Infectious Diseases Society of America, Michigan Infectious Disease Society, Phi Beta Kappa

Disclosure: Nothing to disclose.

Coauthor(s)

Pranatharthi Haran Chandrasekar, MBBS, MD Professor, Chief of Infectious Disease, Department of Internal Medicine, Wayne State University School of Medicine

Pranatharthi Haran Chandrasekar, MBBS, MD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, International Immunocompromised Host Society, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

John L Brusch, MD, FACP Corresponding Faculty Member, Harvard Medical School; Consulting Staff, Department of Medicine and Infectious Disease Service, Cambridge Health Alliance

John L Brusch, MD, FACP is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America; Fellow of the Royal College of Physicians, London

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Medical Association, Association of Professors of Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Additional Contributors

Mark R Wallace, MD, FACP, FIDSA Infectious Disease Physician, Skagit Valley Hospital, Skagit Regional Health

Disclosure: Nothing to disclose.

Rupal M Mody, MD, MPH Staff Physician

Rupal M Mody, MD, MPH is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Acknowledgements

Diane H Johnson, MD Assistant Director, Assistant Professor, Department of Internal Medicine, Division of Infectious Diseases, Winthrop-University Hospital, State University of New York at Stony Brook School of Medicine

Diane H Johnson, MD is a member of the following medical societies: American College of Physicians, American Medical Association, American Medical Women's Association, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Sections Lymphocytic Choriomeningitis Virus (LCMV) Infection
Overview
Presentation
- History
- Physical
- Causes
- Show All
DDx
Workup
Treatment
Follow-up
Tables
References

Diagnosis	Season	Usual Source	Relative Bradycardia	Pharyngitis	Diarrhea	Parotitis	Orchitis	CSF Glucose level
LCMV infection	Fall/winter	Mouse, hamster	+	+/-	-	+/-	+/-	Normal or decreased
Typhoid fever	Year-round	Food, water	+	+	+ (late)	-	-	Normal
Enteroviral illness	Summer	Water	-	+	+	-	-	Normal
Arboviral illness^†	Summer	Mosquito	-	-	-	-	-	Normal
Leptospirosis	Summer/fall	Dogs, rats	-	-	-	-	-	Normal
Influenza	Winter	Person	-	+	-	-	-	Normal
Mumps	Winter/spring	Person	-	-	-	+	+/-	Normal or decreased

Lymphocytic Choriomeningitis Virus (LCMV) Infection Workup

Laboratory Studies

References

Tables

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