Diagnostic performance of a multiplex PCR assay for meningitis in an HIV-infected population in Uganda

Joshua Rhein, Nathan C. Bahr, Andrew C. Hemmert, Joann L. Cloud, Satya Bellamkonda, Cody Oswald, Eric Lo, Henry Nabeta, Reuben Kiggundu, Andrew Akampurira, Abdu Musubire, Darlisha A. Williams, David B. Meya, David R. Boulware, Jane Francis Ndyetukira, Cynthia Ahimbisibwe, Florence Kugonza, Sruti S. Velamakanni, Alice Namudde, Alisat SadiqTadeo Kiiza Kandole, Julian Kaboggoza, Eva Laker, Tony Luggya, Liliane Tugume, Elissa Butler, Jonathan Dyal, Julie Neborak, Lexie King, Nathan Yueh, Kathy Huppler Hullsiek, Ryan Halupnick, Paul R. Bohjanen, Andrew Kambugu, ASTRO-CM Team

Research output: Contribution to journalArticlepeer-review

62 Scopus citations


Meningitis remains a worldwide problem, and rapid diagnosis is essential to optimize survival. We evaluated the utility of a multiplex PCR test in differentiating possible etiologies of meningitis. Cerebrospinal fluid (CSF) from 69 HIV-infected Ugandan adults with meningitis was collected at diagnosis (n = 51) and among persons with cryptococcal meningitis during therapeutic lumbar punctures (n = 68). Cryopreserved CSF specimens were analyzed with BioFire FilmArray® Meningitis/Encephalitis panel, which targets 17 pathogens. The panel detected Cryptococcus in the CSF of patients diagnosed with a first episode of cryptococcal meningitis by fungal culture with 100% sensitivity and specificity and differentiated between fungal relapse and paradoxical immune reconstitution inflammatory syndrome in recurrent episodes. A negative FilmArray result was predictive of CSF sterility on follow-up lumbar punctures for cryptococcal meningitis. EBV was frequently detected in this immunosuppressed population (n = 45). Other pathogens detected included: cytomegalovirus (n = 2), varicella zoster virus (n = 2), human herpes virus 6 (n = 1), and Streptococcus pneumoniae (n = 1). The FilmArray Meningitis/Encephalitis panel offers a promising platform for rapid meningitis diagnosis.

Original languageEnglish (US)
Pages (from-to)268-273
Number of pages6
JournalDiagnostic Microbiology and Infectious Disease
Issue number3
StatePublished - Mar 1 2016

Bibliographical note

Funding Information:
Research support for aspects of this project was received from the National Institutes of Allergy and Infectious Disease, the National Institute of Neurologic Disorders and Stroke, and the Fogarty International Center of the National Institutes of Health (R01NS086312, U01AI089244, T32AI055433, R25TW009345).


  • Cryptococcal meningitis
  • Diagnostics
  • HIV
  • Immunocompromised
  • Meningitis
  • PCR

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