Diagnosis of enterovirus infection by polymerase chain reaction of multiple specimen types

Enteroviruses (EVs) are the most common cause of aseptic meningitis and nonspecific febrile illness among children in the United States. The utility of diagnosis of EV infection by viral culture (VC) is limited by a sensitivity of only 65 to 75%, a turnaround time of 3 to 10 days and the high degree of technical expertise required. The PCR has been shown to be an effective alternative to VC in diagnosing EV meningitis using cerebrospinal fluid (CSF) specimens as well as in diagnosing neonatal EV infections with serum and urine specimens. The development of a 5-h colorimetric microwell detection PCR-based kit (AMPLICOR registered EV Test; Roche Diagnostic Systems, Branchburg, NJ) has greatly simplified EV diagnosis by PCR and reduced the chances of carryover contamination. In a blinded, prospective, multicenter study of children of all ages, we compared the AMPLICOR registered EV Test with VC for the diagnosis of EV infections using CSF, serum, throat and urine samples.