Laboratory Lab results are too important to go anywhere else.

Meningitis/Encephalitis Panel PCR

Meningitis, Encephalitis, Viral, Virus, Bacterial, Bacterial, Fungal, Fungus, Escherichia coli K1, Haemophilus influenzae, Listeria monocytogenes, Streptococcus agalactiae, Group B Strep, Streptococcus pneumoniae, cytomegalovirus, CMV, Enterovirus, EV, Herpes simplex virus 1, Herpes simplex virus 2, HSV, Human herpesvirus 6, HHV6, Human parechovirus, HPeV, Varicella zoster virus, VZV, MEPNG

Test Codes

EPIC: LAB1231022

Department

Microbiology

Specimen Collection Criteria

Collect: Cerebrospinal Fluid (CSF): 1.0 mL CSF in a sterile collection container. (Minimum: 0.25 mL) CSF specimens should be collected via lumbar puncture and should not be centrifuged.

Special Specimen Collection and Handling Notes

• To minimize false positive test results, medical staff must wear a surgical mask and sterile gloves to avoid the inadvertent transfer of microorganisms from their bodies into the collection tubes during the lumbar puncture procedure.  Additionally, similar precautions should be extended to family members present during the procedure.

• This test should NOT be ordered on patients with an indwelling CNS medical device.

• Testing should only be performed on CSF collection tube (#2) designated for Microbiology.

• Testing will not be repeated on a patient within 30 days of the initial result, unless approved by an Infectious Diseases physician or the Medical or Technical Director of Microbiology.

Physician Office/Draw Specimen Preparation

Do not freeze specimens. Maintain room temperature (20-26°C or 68-78.8°F) or refrigerated (2-8°C or 36-46°F) prior to transport and arrange for a STAT transportation to the Microbiology Lab. Courier Services can be contacted for a STAT pickup at 1-800-551-0488.

If ordered, CSF Culture must be set up immediately and prior to prolonged storage at refrigerator temperature.

Preparation for Courier Transport

Transport: Room temperature (20-26°C or 68-78.8°F) or refrigerated (2-8°C or 36-46°F).

Rejection Criteria

• Frozen specimens.
• Specimens not maintained in a sterile environment prior to receipt in the lab.

In-Lab Processing

Do not freeze specimens. Refrigerate (2-8°C or 36-46°F) specimens if testing will not be performed within 24 hours of the time of collection.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 24 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 30 days

Laboratory

Royal Oak Microbiology Laboratory

Performed

Sunday – Saturday.
Results available within 3 hours upon receipt into the Microbiology Lab.

Reference Range

Negative for all tested targets.

Test Methodology

FilmArray ME Panel (FDA-approved) – qualitative, multiplex Polymerase Chain Reaction (PCR) and high-resolution melting curve analysis.

Interpretation

A negative result suggests that nucleic acid of any of the tested organisms was not present in the sample.

A negative result should not rule-out central CNS infection in patients with a high pretest probability for meningitis or encephalitis. The assay does not test for all potential infectious agents of CNS disease. Negative results should be clinically correlated.

This test is not intended for use with CSF collected from indwelling medical devices (e.g., CSF shunts).

Detection of multiple viruses or bacteria or viruses and bacteria may be observed with this test. In these situations, the clinical history and presentation should be reviewed thoroughly to determine the clinical significance of multiple pathogens in the same specimen.

False-negative results for herpes simplex virus (HSV) may occur. In cases where there is a clinical suspicion for HSV and the ME panel is negative for HSV, clinicians should order Herpes Simplex Virus PCR.

False-negative results for Cryptococcus neoformans/gattii may occur in patients with cryptococcal meningitis. Cryptococcal Antigen test should be considered on CSF if the ME panel is negative for Cryptococcus neoformans/gattii and there is a high clinical suspicion for cryptococcal meningitis. Cryptococcal antigen testing on serum may also be indicated.

Human herpesvirus 6 (HHV-6) or cytomegalovirus (CMV): Can exist in a latent form that is reactivated during infection due to other pathogens, including agents not detected by the FilmArray ME panel that may cause meningitis or encephalitis (e.g., Mycobacterium tuberculosis or HIV). Chromosomally integrated HHV-6 may result in a positive result. When detected by the FilmArray ME, HHV-6 or CMV should be considered as the likely cause of meningitis or encephalitis only in appropriate clinical settings and following expert consultation.

Only encapsulated strains of N. meningitidis will be detected by the BIOFIRE ME Panel. Unencapsulated N. meningitidis will not be detected.

Viral shedding into the CSF often occurs in cases of zoster (shingles; caused by reactivation of VZV). Detection of VZV in CSF may not indicate the cause of CNS disease in these cases.

False positive results can be caused by contamination of specimens or the test with organisms shed by otherwise healthy individuals. S. pneumoniae and H. influenzae can be shed from the respiratory tract of healthy individuals. HSV-1 may also be shed from individuals with active or recurrent cold sores.

The BIOFIRE ME Panel Enterovirus assay can cross-react with human rhinoviruses. Human rhinoviruses are genetically very similar to enteroviruses and can be shed from the respiratory tract of healthy individuals or those with signs and symptoms of a respiratory tract infection. However, rhinoviruses are rarely present in human cerebrospinal fluid and are not a recognized cause of meningitis. Caution should be exercised during specimen collection and testing to prevent contamination with rhinovirus. 

Clinical Utility

This test is indicated as an aid in the diagnosis of specific agents of meningitis and/or encephalitis. Test results should be used in conjunction with other clinical, epidemiological and laboratory data and NOT as the sole basis for diagnosis, treatment or patient management decisions. Not all agents of CNS infection are detected by this test and positive results do not rule out co-infection with organisms not included in this assay.

This assay provides a rapid, highly sensitive and specific test for the detection of the following viruses, bacteria and fungi associated with meningitis and encephalitis.

Bacteria:

• Escherichia coli K1 *
• Haemophilus influenzae
• Listeria monocytogenes
• Neisseria meningitidis (encapsulated) *
• Streptococcus agalactiae
• Streptococcus pneumoniae

(*) This test can NOT detect non-K1 E. coli serotypes or non-encapsulated strains of Neisseria meningitidis.

Viruses:

• Cytomegalovirus *
• Enterovirus
• Herpes simplex virus 1
• Herpes simplex virus 2
• Human herpesvirus 6 *
• Human parechovirus
• Varicella zoster virus

(*) This test can NOT distinguish between latent or active infection due to cytomegalovirus (CMV) or Human Herpes virus 6 (HHV-6).

Yeast:

• Cryptococcus neoformans/gattii

Clinical Disease

Central nervous system (CNS) infections are responsible for causing inflammatory conditions of the brain and/or meningeal tissues surrounding the brain (i.e. meningitis, encephalitis, meningoencephalitis). Approximately 15% of cases are fatal and many other cases result in life-long disabilities such as loss of limbs, visual and hearing deficits, seizures, and altered learning and memory.

Epidemiology

Variable

Incubation Period

Variable

Transmission

Variable

CPT Codes

87483
LOINC:  Escherichia coli K1 61398-4, Haemophilus influenza 61366-1, Listeria monocytogenes 61369-5, Streptococcus agalactia 48683-7, Streptococcus pneumoniae 49672-9, Cytomegalovirus 30326-3, Enterovirus 29558-4, Human Herpes Virus 6 33942-4, Herpes Simplex Virus 1 16952-4, Herpes Simplex Virus 2 16960-7, Human Parechovirus 51669-0, Varicella Zoster Virus 21598-8

Contacts

Last Updated

8/29/2025