Rapid Diagnostic Tests for Meningitis and Encephalitis—BioFire
Open accessAbstract
Meningitis and encephalitis (ME) are important causes of morbidity and mortality worldwide. Patients suspected of having ME are often hospitalized and started on empiric antimicrobial treatment, because of the potential adverse consequences of delaying the diagnosis or treatment. Multiplexed polymerase chain reaction panels are one of several rapid diagnostic technologies that have the potential to overcome some of the limitations of conventional diagnostic methods for ME. The BioFire FilmArray Meningitis/Encephalitis Panel was the first Food and Drug Administration–cleared multiplex polymerase chain reaction for the evaluation of cerebrospinal fluid samples, able to identify 14 organisms in a single test reaction. This newer rapid diagnostic tool has an overall high sensitivity and specificity for the diagnosis of ME with a fast turnaround time and has the potential to improve resource utilization for patients presenting with suspicion of ME. However, further research is needed to determine its optimal use in the evaluation of patients with suspected ME.
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In this study, with a relatively small sample size, the positive and negative percent agreements of QIA/ME and FA/ME were slightly better than the specificity and sensitivity values seen in previous studies evaluating FA/ME.
“In this study, with a relatively small sample size, the positive and negative percent agreements of QIA/ME and FA/ME (Tables 3 to 5) were slightly better than the specificity and sensitivity values seen in previous studies evaluating FA/ME (17–24).”
From Evaluation of the Novel CE-IVD-Marked Multiplex PCR QIAstat-Dx Meningitis/Encephalitis Panel (2023) · cites this paper as [21]
Herpesviruses included in the ME panel (HSV-1, HSV-2, CMV, VZV, and HHV-6) can enter a latent state; positive results may reflect latent viral genomes carried by CSF leukocytes or peripheral blood contamination from a traumatic lumbar puncture instead of genuine CNS involvement.
“The interpretive challenge is heightened by the inherent capacity of the herpesviruses included in the ME panel (HSV‐1, HSV‐2, CMV, VZV, and HHV‐6) to enter a latent state. As a result, positive results may reflect latent viral genomes carried by CSF leukocytes or peripheral blood contamination from a traumatic lumbar puncture instead of genuine CNS involvement [20].”
From Real‐World Evaluation of the BioFire FilmArray ME Panel: Diagnostic Accuracy and Clinical Utility (2026) · cites this paper as [20]
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“2% or greater for all 14 organisms.(25) A recent meta-analysis by Tansarli and Chapin(12) identified 8 studies that provide data required to estimate the performance of theME Panel through the evaluation of discordant results between the ME Panel and reference methods.”
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Sugden, S., Reynoso, D., Mathew, R., & Loeffelholz, M. J. (2025) · Transplant Infectious Disease · doi:10.1111/tid.70140 · Cited by 1 · see citing works
Elsberg Syndrome: A Case Report of a Novel Radiographic Presentation
Lyons, C. E., & Dixit, K. (2024) · The Neurohospitalist · doi:10.1177/19418744241241107 · Cited by 1 · see citing works
Diagnostic challenges in neuroinfections: case report and literature review
Chitu, M.-C., Salmen, T., Mihai, B.-M., Dima, V., Potcovaru, C.-G., Cinteză, D., Bohîlțea, R. E., Raducanu, P.-R., Marcu, D., Mischianu, D. L. D., et al. (2022) · Romanian Journal of Infectious Diseases · doi:10.37897/rjid.2022.2.4
Mukti, M. I., Aryati, A., & Sugianto, P. (2023) · Bali Medical Journal · doi:10.15562/bmj.v12i3.4781
Encephalitis and Meningoencephalitis
Bronstein, D. E., & Glaser, C. A. (2025) · Elsevier eBooks · doi:10.1016/b978-0-323-82763-8.00036-4
Bhatt, P., Shilimkar, V., Tewatia, J., & Karade, S. K. (2025) · Journal of Pure and Applied Microbiology · doi:10.22207/jpam.19.2.55
Calthrop, A., Shabbir, A., Burnett, C., & Walden, A. (2025) · BMJ Case Reports · doi:10.1136/bcr-2024-264709
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The clinical impact of herpesvirus testing on multiplex PCR panels in a pediatric population
Li, C. N., Thompson, C. M., Hunter, B., Dobler, E. A., Jachym, N., Mohsin, E., Malakooti, M., & Akhtar, L. N. (2025) · Antimicrobial Stewardship & Healthcare Epidemiology · doi:10.1017/ash.2025.10242
Flannery, D. D., Proaño, Á., & Srinivasan, L. (2026) · Cambridge University Press eBooks · doi:10.1017/9781009418034.033
- Authors
- Fleischer, E., & Aronson, P. L.
- Affiliations
- Yale University (US)
- Corresponding author
- Fleischer, Eduardo
- ORCID
- Aronson, Paul L.
- Venue
- Pediatric Emergency Care
- Published
- 2020-08
- Volume
- 36
- Issue
- 8
- Pages
- 397-401
- ISSN
- 0749-5161 (ISSN-L)
- 1535-1815
- PMC
- PMC7703746
- OpenAlex
- W3046350504
- Cited by
- 28
- References
- 68
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 2 · 2023: 5 · 2022: 5 · 2021: 4
- FWCI
- 0.44
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Pediatric Emergency Care (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR001863)
- Agency for Healthcare Research and Quality (K08HS026006)
- National Center for Advancing Translational Sciences
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Keywords
- meningitis, encephalitis, rapid diagnostic tests, multiplex PCR, cerebrospinal fluid, pathogen detection, sensitivity and specificity, pediatric patients
- MeSH terms
- Diagnostic Tests, Routine, Encephalitis, Humans, Meningitis, Molecular Diagnostic Techniques
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