Cerebrospinal fluid testing
Precision answers to guide care
Central nervous system infections (CNS), among them meningitis, encephalitis, and brain abscesses, can be devastating to affected patients and are associated with substantial mortality and long-term effects.1 Treatment for certain infections is available. Identifying the type of infection through accurate laboratory diagnosis can lead to ideal outcomes.
The broad range of pathogenic causes for CNS infections, which include bacteria, fungi, viruses, and parasites, can present a diagnostic challenge. Certain clinical diagnostic methods, such as culture and specific PCR assays, are limited in the ability to detect nonviable organisms or nucleic acids not targeted by specific assays, respectively. Unbiased metagenomic sequencing overcomes diagnostic test limitations by interrogating microbiota without bias toward viable or specific microorganism(s).
Cerebrospinal fluid test menu
Cerebrospinal fluid metagenomic testing
Shotgun metagenomic sequencing holistically sequences all the DNA and RNA present in cerebrospinal fluid. Bioinformatic analysis of those sequences identifies the presence of all pathogens, including viruses, bacteria, parasites, and fungi. Our world-renowned clinical microbiology physicians interpret results and provide clinical consultation, as needed. A broad menu of microbiology tests is immediately available to confirm or follow up on unusual or confusing findings.
Key testing
- MSCSF | Bacteria, Virus, Fungus, and Parasite Metagenomic Sequencing, Spinal Fluid
- Wide and unbiased assessment that uses next-generation sequencing to identify multiple pathogens, if present.
- Detects and identifies more than 1,000 types of bacteria, DNA and RNA viruses, fungi, and parasites.
- Can quickly end lengthy diagnostic odysseys.
- Results are reviewed and interpreted by Mayo Clinic clinical microbiology experts.
Highlights
In this episode of “Answers From the Lab,” host Bobbi Pritt, M.D., chair of the Division of Clinical Microbiology at Mayo Clinic, is joined by William Morice II, M.D., Ph.D., president and CEO of Mayo Clinic Laboratories and Trish Simner, Ph.D., a clinical microbiologist at Mayo Clinic to discuss recent news about Protecting Access to Medicare Act (PAMA) reform followed by an in-depth conversation about metagenomics.
In this episode of “Answers From the Lab,” host Bobbi Pritt, M.D., chair of the Division of Clinical Microbiology at Mayo Clinic, is joined by Elitza Theel, Ph.D., director of the Infectious Diseases Serology Laboratory at Mayo Clinic, for a timely discussion on tick-borne diseases.
PACE/State of FL - Metagenomic sequencing for diagnosing central nervous system infection. Content will be shared regarding technical details, clinical applications, and results interpretation, drawing on both current literature and practice guidelines.
Central nervous system infections, such as meningitis and encephalitis, can be devastating for affected patients. While specific treatments are available for some of these infections, it first requires identifying the precise cause of infection. To meet that need, Mayo Clinic Laboratories has developed a metagenomics assay that can identify more than 1,000 pathogenic organisms in cerebrospinal fluid. The innovative assay, which uses an approach known as shotgun metagenomic sequencing, is one of the only such tests currently available.
Robin Patel, M.D., explains how a new Mayo Clinic Laboratories' assay can identify central nervous system pathogens that standard tests fail to detect. Rapid, precise diagnosis is essential to preventing long-term effects from these infections.
Autoimmune encephalopathy
Many cases of encephalopathy previously considered infectious are now recognized to have an autoimmune cause. In fact, based on a recent Mayo Clinic study, autoimmune encephalitis was found to be as common as infectious encephalitis.3
Key testing
NOTE: This test is also available using a serum specimen with Mayo ID: ENS2
References
- Giovane RA, Lavender PD. Central nervous system infections. Prim Care. 2018 Sep;45(3):505-518. doi:10.1016/j.pop.2018.05.007. Epub 2018 Jul 9. PMID: 30115337.
- Citation Rodino KG, Toledano M, Norgan AP, et al. 2020. Retrospective review of clinical utility of shotgun metagenomic sequencing testing of cerebrospinal fluid from a U.S. tertiary care medical center. J Clin Microbiol. 58:e01729-20. https://doi.org/10.1128/JCM.01729-20
- Flanagan EP, Dubey D, Pittock SJ, et al. Autoimmune encephalitis epidemiology and a comparison to infectious encephalitis. Ann Neurol. 2018 Jan;83(1):166-177.