Key result
Among 240 patients with aseptic meningitis, a viral etiology was identified in 40.4% using a multiplex PCR panel, with enterovirus (25%) and human herpesvirus 6 (7.9%) being the most common pathogens.
Why the study?
Aseptic meningitis remains challenging to diagnose and is often underreported worldwide, impacting the quality of patient care.
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Cohort (n=240)
No
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Absolute Event Rate: 40.4% vs 59.6%
A multiplex PCR panel identified a viral etiology in 40.4% of aseptic meningitis cases, predominantly enterovirus and HHV-6 in pediatric males, highlighting that the majority of cases remain of unknown etiology.
Supports multiplex PCR in aseptic meningitis; leaves open etiology in most cases and requires prospective validation.
Background: Central nervous system (CNS) infection is associated with high rates of morbidity and mortality, and despite advancements in molecular testing, aseptic meningitis remains challenging to diagnose. Aseptic meningitis cases are often underreported worldwide, which impacts the quality of patient care. Therefore, we aimed to assess the results of BioFire® FilmArray® meningitis/encephalitis (ME) PCR panel, clinical characteristics, and etiologies of aseptic meningitis patients. Methods: From January 2018 to January 2020, all pediatric and adult patients in a large tertiary medical center who underwent lumbar puncture and cerebrospinal fluid (CSF) testing by a ME multiplex PCR panel and who fit the aseptic meningitis definition were retrospectively reviewed. Results: Data were reviewed from 1,607 patients; 240 met the inclusion criteria (54.6% males; 68.8% <4 years of age). The rate of detected viral causes of aseptic meningitis was 40.4%; therefore, 59.6% of the patients remained with unidentified etiology. Among the identified viral meningitis, enterovirus and human herpesvirus 6 (HHV-6) were the most common (25 and 7.9%, respectively). The median length of hospital stay was 6 days, and it was longer in patients with unidentifiable aseptic meningitis ( p < 0.0001). Conclusion: Aseptic meningitis is common among suspected meningitis patients, but most cases remained of unknown etiology. The most common identified viruses were enterovirus followed by HHV-6, and there is predominance in males and the pediatric age group. These results highlight that further research is needed to identify other etiologies and possible additional viral pathogens for aseptic meningitis in the current diagnostic methods.
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Aldriweesh et al. (2020) conducted a cohort in Aseptic meningitis (n=240). Viral etiology (detected via multiplex PCR panel) vs. Unknown etiology (negative PCR) was evaluated on Rate of detected viral causes of aseptic meningitis. Among 240 patients with aseptic meningitis, a viral etiology was identified in 40.4% using a multiplex PCR panel, with enterovirus (25%) and human herpesvirus 6 (7.9%) being the most common pathogens.
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