Lymphocytic Choriomeningitis Virus (LCMV) Infection Workup

Updated: Sep 11, 2017
  • Author: Philip J McDonald, MD; Chief Editor: Burke A Cunha, MD  more...
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Workup

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)