Infectious Meningitis and Encephalitis

Piquet, Amanda L.; Lyons, Jennifer L.

doi:10.1055/s-0036-1585099

Cited by 5 publications

(1 citation statement)

References 19 publications

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“…When interpreting CSF glucose levels they should be compared with plasma levels [31]. CSF/blood glucose level is typically low in bacterial and tuberculous meningitis, but can also be seen with other causes as well [3,27,32,33].…”

Section: Host Factorsmentioning

confidence: 99%

Methods for Rapid Diagnosis of Meningitis Etiology in Adults

2020

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Infectious meningitis can be caused by viral, bacterial or fungal pathogens. Despite widely available treatments, many types of infectious meningitis are still associated with significant morbidity and mortality. Delay in diagnosis contributes to poor outcomes. Cerebrospinal fluid cultures have been used traditionally but are time intensive and sensitivity is decreased by empiric treatment prior to culture. More rapid techniques such as the cryptococcal lateral flow assay (IMMY), GeneXpert MTB/Rif Ultra (Cepheid) and FilmArray multiplex-PCR (Biofire) are three examples that have drastically changed meningitis diagnostics. This review will discuss a holistic approach to diagnosing bacterial, mycobacterial, viral and fungal meningitis.

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Section: Host Factorsmentioning

confidence: 99%

Methods for Rapid Diagnosis of Meningitis Etiology in Adults

2020

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Overview of cerebrospinal fluid cytology

Rahimi

Wöehrer

2018

Handbook of Clinical Neurology

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Circulating epithelial tumor cell analysis in CSF in patients with leptomeningeal metastases

et al. 2020

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ObjectiveThe primary objective was to determine the sensitivity and specificity of epithelial cell adhesion molecule (EpCAM) immunoflow cytometry circulating tumor cells (CTC) analysis in CSF in patients with suspected leptomeningeal metastases (LM). The secondary objective was to explore the distribution of driver mutations in the primary tumor, plasma, cell free CSF (cfCSF), and isolated CTC from CSF in non-small cell lung cancer (NSCLC).MethodsWe tested the performance of the CTC assay vs CSF cytology in a prospective study in 81 patients with a clinical suspicion of LM but a nonconfirmatory MRI. In an NSCLC subcohort, we analyzed circulating tumor (ct)DNA of the selected driver mutations by digital droplet PCR (ddPCR).ResultsThe sensitivity of the CTC assay was 94% (95% confidence interval [CI] 80–99) and the specificity was 100% (95% CI 91–100) at the optimal cutoff of 0.9 CTC/mL. The sensitivity of cytology was 76% (95% CI 58–89). Twelve of the 23 patients with NSCLC had mutated epidermal growth factor receptor (EGFR). All 5 tested patients with LM demonstrated the primary EGFR driver mutation in cfCSF. The driver mutation could also be detected in CTC isolated from CSF.ConclusionCTC in CSF are detected with a high sensitivity for the diagnosis of LM. ddPCR can determine EGFR mutations in both cfCSF and isolated CTC from CSF of patients with EGFR-mutated NSCLC and LM.Classification of evidenceThis study provides Class III evidence that EpCAM-based immunoflow cytometry analysis of CSF accurately identifies patients with LM.

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Infectious Meningitis and Encephalitis

Cited by 5 publications

References 19 publications

Methods for Rapid Diagnosis of Meningitis Etiology in Adults

Methods for Rapid Diagnosis of Meningitis Etiology in Adults

Overview of cerebrospinal fluid cytology

Circulating epithelial tumor cell analysis in CSF in patients with leptomeningeal metastases

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