Lymphocytic Choriomeningitis - LCM

Diagnosis

Indications for Testing

Laboratory Testing

  • Antibody testing by complement fixation of serum and cerebrospinal fluid

Differential Diagnosis

Clinical Background

Lymphocytic choriomeningitis (LCM) virus is spread by rodents. It can be deadly to immunocompromised patients but rarely affects healthy individuals.

Epidemiology

  • Incidence – <5% seropositivity in U.S. adults
  • Transmission
    • Rodents are the primary reservoir
    • Transmission to humans
      • Aerosolization of excreta and secreta of the common house mouse, pet hamster, and pet rat
      • Recent reports of solid organ transplant transmission

Organism

  • RNA virus in the Arenaviridae family

Risk Factors

  • Immunocompromised state
  • Pregnancy

Clinical Presentation

  • Symptoms develop 5-10 days after exposure
    • Infection usually presents as an acute influenza-like illness
      • Most patients develop fevers of 101-104° F with chills and muscle rigidity
    • Other symptoms may include malaise, retro-orbital headache, photophobia, weakness, anorexia, nausea, light-headedness, and sore throat
  • Symptoms usually improve within 5 days to 3 weeks; patients may suffer relapse with meningeal symptoms
  • Suspect in patients with marked leukopenia and thrombocytopenia on presentation
  • Associated conditions – orchitis, aseptic meningitis, transient alopecia, and maculopapular rash
  • Congenital infections may cause stillbirths – hydrocephalus, chorioretinitis, or TORCH-negative hydrocephalus

Treatment

  • Treatment is symptomatic

Indications for Laboratory Testing

  • Tests generally appear in the order most useful for common clinical situations
  • Click on number for test-specific information in the ARUP Laboratory Test Directory
Test Name and Number Recommended Use Limitations Follow Up
Lymphocytic Choriomeningitis (LCM) Virus Antibodies, IgG & IgM 2001635
Method: Semi-Quantitative Indirect Fluorescent Antibody

Identify LCM as pathogen for meningitis

   
Lymphocytic Choriomeningitis (LCM) Virus Antibodies, IgG & IgM, CSF 2001628
Method: Semi-Quantitative Indirect Fluorescent Antibody

Identify LCM as pathogen for meningitis 

   
Additional Tests Available
 
Click the plus sign to expand the table of additional tests.
Test Name and NumberComments
Encephalitis Panel with Reflex to Herpes Simplex Virus Types 1 and 2 Glycoprotein G-Specific Antibodies, IgG, CSF 2008916
Method: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Chemiluminescent Immunoassay
Encephalitis Panel with Reflex to Herpes Simplex Virus Types 1 and 2 Glycoprotein G-Specific Antibodies, IgG, Serum 2008915
Method: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Chemiluminescent Immunoassay
Meningoencephalitis Panel with Reflex to Herpes Simplex Virus Types 1 and 2 Glycoprotein G-Specific Antibodies, IgG, CSF 2008917
Method: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody/Semi-Quantitative Chemiluminescent Immunoassay
Meningoencephalitis Panel with Reflex to Herpes Simplex Virus Types 1 and 2 Glycoprotein G-Specific Antibodies, IgG, Serum 2008918
Method: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody/Semi-Quantitative Chemiluminescent Immunoassay
Lymphocytic Choriomeningitis (LCM) Virus Antibody, IgG, CSF 2001629
Method: Semi-Quantitative Indirect Fluorescent Antibody
Lymphocytic Choriomeningitis (LCM) Virus Antibody, IgG 2001633
Method: Semi-Quantitative Indirect Fluorescent Antibody
Lymphocytic Choriomeningitis (LCM) Virus Antibody, IgM 2001634
Method: Semi-Quantitative Indirect Fluorescent Antibody
Lymphocytic Choriomeningitis (LCM) Virus Antibody, IgM, CSF 2001630
Method: Semi-Quantitative Indirect Fluorescent Antibody