Evidence map›Paper›PMID 38543707›Full record

ArticleViruses2024

A Specific Pattern of Routine Cerebrospinal Fluid Parameters Might Help to Identify Cases of West Nile Virus Neuroinvasive Disease.

Johann Otto Pelz, Christoph Mühlberg, Isabel Friedrich, Lorenz Weidhase, Silke Zimmermann, Melanie Maier, Corinna Pietsch

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Viruses, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.6field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 4 citations in OpenAlex.

  1. Integrating metagenomics and metatranscriptomics intoThe Journal of general virology · 2026
    Review
  2. Review
  3. Article
  4. Seroprevalence of West Nile Virus in Blood Donors in Mainland Portugal.Tropical medicine and infectious disease · 2025
    Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Johann Otto PelzDepartment of Neurology, University Hospital Leipzig, 04103 Leipzig, Germany.ORCID 0000-0003-4391-2280
Christoph MühlbergDepartment of Neurology, University Hospital Leipzig, 04103 Leipzig, Germany.
Isabel FriedrichDepartment of Neurology, University Hospital Leipzig, 04103 Leipzig, Germany.
Lorenz WeidhaseMedical Intensive Care Unit, University Hospital Leipzig, 04103 Leipzig, Germany.
Silke ZimmermannInstitute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, 04103 Leipzig, Germany.ORCID 0000-0001-9644-8907
Melanie MaierDepartment of Virology, Institute of Medical Microbiology and Virology, University Hospital Leipzig, 04103 Leipzig, Germany.ORCID 0000-0003-4158-1473
Corinna PietschDepartment of Virology, Institute of Medical Microbiology and Virology, University Hospital Leipzig, 04103 Leipzig, Germany.ORCID 0000-0001-6029-3368
University Hospital Leipzig · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundViral meningitis/encephalitis (ME) is a rare but potentially harmful disease. The prompt identification of the respective virus is important to guide not only treatment but also potential public health countermeasures. However, in about 40% of cases, no virus is identified despite an extensive diagnostic workup. The aim of the present study was to analyze demographic, seasonal, and routine cerebrospinal fluid (CSF) parameters in cases of viral ME and assess their utility for the prediction of the causative virus.

methodsDemographic data, season, and routine CSF parameters (total leucocytes, CSF cell differentiation, age-adjusted CSF/serum albumin ratio, and total immunoglobulin ratios) were retrospectively assessed in cases of viral ME.

resultsIn total, 156 cases of acute viral ME (74 female, median age 40.0 years) were treated at a tertiary-care hospital in Germany. Specific viral infections were detected in 93 (59.6%) cases. Of these, 14 (9.0%) cases were caused by herpes simplex virus (HSV), 36 (23.1%) by varicella-zoster virus (VZV), 27 (17.3%) by enteroviruses, 9 (5.8%) by West Nile virus (WNV), and 7 (4.5%) by other specific viruses. Additionally, 64 (41.0%) cases of ME of unknown viral etiology were diagnosed. Cases of WNV ME were older, predominantly male, showed a severe disruption of the blood-CSF-barrier, a high proportion of neutrophils in CSF, and an intrathecal total immunoglobulin M synthesis in the first CSF sample. In a multinominal logistic regression analysis, the accuracy of these CSF parameters together with age and seasonality was best for the prediction of WNV (87.5%), followed by unknown viral etiology (66.7%), VZV (61.8%), and enteroviruses (51.9%).

conclusionsCases with WNV ME showed a specific pattern of routine CSF parameters and demographic data that allowed for their identification with good accuracy. These findings might help to guide the diagnostic workup in cases with viral ME, in particular allowing the timely identification of cases with ME due to WNV.

Indexed as

Encephalitis, ViralEnterovirus InfectionsMeningitis, ViralVirusesWest Nile FeverWest Nile virusAdultAntibodies, ViralFemaleHerpesvirus 3, HumanHumansMaleRetrospective StudiesAntibodies, Viralcerebrospinal fluidclimate changeencephalitisimmunoglobulin MmeningitisWest Nile virus

Identifiers

PMID38543707
PMCPMC10974314
OpenAlexW4392034070

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.