Lymphocytic Choriomeningitis - LCM

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

Diagnosis

Indications for Testing

Immunocompromised patient with influenza-like illness and associated meningitis

Laboratory Testing

Antibody testing by complement fixation of serum and cerebrospinal fluid (CSF)

Differential Diagnosis

Background

Epidemiology

  • Incidence – <5% seropositivity in U.S. adults
  • Transmission
    • Primary reservoir – rodents
    • 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
    • Presents as an acute influenza-like illness – fever of 101-104° F with chills and muscle rigidity
    • Other symptoms – 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 (toxoplasmosis, other, rubella, cytomegalovirus, herpes simplex virus)-negative hydrocephalus

ARUP Laboratory Tests

Aid in diagnosis of LCM viral infection

Aid in diagnosis of LCM viral infection in the central nervous system

Related Tests

Molecular testing is preferred for patients presenting with meningitis/encephalitis; refer to meningitis/encephalitis panel by polymerase chain reaction (PCR)

Not a preferred test; refer to relevant test for specific pathogen suspected

Not recommended as a stand-alone test

Panel that includes LCM virus IgG and IgM antibodies is preferred

Not recommended as a stand-alone test for identifying LCM virus as pathology for meningitis

Panel that includes IgG and IgM antibodies is preferred

Medical Experts

Contributor

Couturier

Marc Roger Couturier, PhD, D(ABMM)
Associate Professor of Clinical Pathology, University of Utah
Medical Director, Parasitology/Fecal Testing, Infectious Disease Antigen Testing, Bacteriology, and Molecular Amplified Detection, ARUP Laboratories
Contributor

Slev

Patricia R. Slev, PhD
Associate Professor of Clinical Pathology, University of Utah
Section Chief, Immunology; Medical Director, Immunology Core Laboratory, ARUP Laboratories

References

Additional Resources