Meningitis Routine Laboratory Results
Specific Markers
PCR
- May vary from center to center, but generally will detect E. coli, H. influenzae, N. meningitidis, Listeria monocytogenes, Streptococcus agalactiae, Streptococcus pneumoniae, CMV, Enterovirus, HSV 1/2, HHV-6, Human parechovirus, VZV, and Cryptococcus neoformans/gattii
ADA (Adenosine Deaminase)
- Sensitivity and specificity for tuberculous meningitis varies depending cutoff level, however, approaches 80% and 90% on average, respectively (1)
Cryptococcal Antigen
- Sensitivities ~93-100%, with specificities ~93-98% for cryptococcal meningitis (2)
14-3-3 Protein
- Sensitivity ~93%, specificity ~80% for spontaneous Creutzfeld-Jakob Disease (sCJD) (3)
Oligoclonal Bands
- Sensitivity 75–92%, specificity 86–92%, negative predictive value 97% for Multiple Sclerosis (4)
Aβ42 Protein
- Correlates with Alzheimer’s Disease, but no good data for sensitivity or specificity. Not recommended for routine diagnosis (5)
References
- Ekermans, P., Dusé, A., & George, J. (2017, January 31). The dubious value of cerebrospinal fluid adenosine deaminase measurement for the diagnosis of tuberculous meningitis. BMC Infectious Diseases. https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-017-2221-3.
- Tanner DC;Weinstein MP;Fedorciw B;Joho KL;Thorpe JJ;Reller L; (n.d.). Comparison of commercial kits for detection of cryptococcal antigen. Journal of clinical microbiology. https://pubmed.ncbi.nlm.nih.gov/7929757/.
- Muayqil, T., Gronseth, G., & Camicioli, R. (2012, October 2). Evidence-based guideline: diagnostic accuracy of CSF 14-3-3 protein in sporadic Creutzefldt-Jakob disease: report of guideline development subcommittee of the American Academy of Neurology. Neurology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3525296/.
- Ferraro, D., et al (2020). Kappa Index versus CSF Oligoclonal Bands inPredicting Multiple Sclerosis andInfectious/Inflammatory CNS Disorders. Diagnostics
- McKhann, G. M., Knopman, D. S., Chertkow, H., Hyman, B. T., Jack, C. R., Kawas, C. H., Klunk, W. E., Koroshetz, W. J., Manly, J. J., Mayeux, R., Mohs, R. C., Morris, J. C., Rossor, M. N., Scheltens, P., Carrillo, M. C., Thies, B., Weintraub, S., & Phelps, C. H. (2011, May). The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimer’s & dementia : the journal of the Alzheimer’s Association. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312024/.