What is the role of polymerase chain reaction (PCR) testing in the diagnosis of meningitis?

Updated: Jul 16, 2019
  • Author: Rodrigo Hasbun, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

The use of nucleic acid amplification (eg, polymerase chain reaction [PCR] testing) has revolutionized the diagnosis of herpes simplex virus (HSV) meningitis. The availability of this technique has confirmed HSV as the cause of the recurrent Mollaret meningitis. This technique has also been applied to the diagnosis of enteroviral infections and the other herpesvirus infections. The PCR assay for enteroviruses has been demonstrated to be substantially more sensitive than culture and is 94-100% specific.

A multiplex PCR panel that identifies 14 pathogens (E coli K1, H influenzae, L monocytogenes, N meningitidis, S agalactiae, S pneumoniae, cytomegalovirus, enterovirus, herpes simplex virus 1, herpes simplex virus 2, human herpes virus 6, human parechovirus, varicella zoster, C neoformans/Cryptococcus gattii) in 1 hour with 0.2 mL of CSF is now widely available.


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