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Meningitis: Fast Diagnostics for a Deadly Disease

Meningitis is a deadly disease that can kill in hours. This is a serious condition that can lead to inflammation (swelling) of the protective membranes covering the brain and spinal cord. However, injuries, cancer, certain drugs, and other types of infections can also cause meningitis. It is important to know the specific cause of meningitis because the treatment differs depending on the cause.1

The History of Meningitis

As meningitis diagnostics are relatively recent in our history, it's difficult to determine exactly how long the disease has been a part of our world. "The first recorded observation of what might have been meningitis came from the famous Greek scholar Hippocrates (c.460-370BC), who observed the inflammation of the lining of the brain," according to the Meningitis Research Foundation.2

In 1661, Thomas Willis provided one of the earliest descriptions of meningitis. He depicted  patients with "inflammation of the meninges with a continual fever" in 1661.2

French and English physicians coined the term "meningitis" in the early 1800s by combining "meninges" with the suffix "itis" to imply inflammation. Since then, scientists have delineated different types of meningitis.2

Depiction of Thomas Willis, SciHi Blog

Causes of Meningitis

Infectious meningitis can be caused by bacteria, viruses, or yeast. Meningitis-causing bacteria and viruses can be spread from person to person. Some bacteria can spread through food. Fungal meningitis, caused by yeast organisms, generally begins as an infection elsewhere in the body that spreads to the meninges.

Meningitis symptoms include sudden onset of:3

  • Fever
  • Headache
  • Stiff neck

There are often other symptoms, such as:3

  • Nausea
  • Vomiting
  • Photophobia (eyes being more sensitive to light)
  • Altered mental status (confusion)

Newborns and babies may not have, or it may be difficult to notice the classic symptoms listed above. Instead, babies may:3

  • Be slow or inactive
  • Be irritable
  • Vomit
  • Feed poorly
  • Have a bulging fontanelle (the "soft spot" on a baby's head)
  • Have abnormal reflexes

Every Minute Counts When it Comes to Meningitis

Meningitis is a serious infection of the meninges; it is a devastating disease and remains a major public health challenge. While the disease can be caused by many different pathogens, the highest global burden is seen with bacterial meningitis.3

Distinguishing bacterial from viral meningitis based on clinical presentation alone is challenging. Getting fast, pathogen-specific answers can help save lives and guide appropriate therapy. That's because time to diagnosis is critical. Bacterial meningitis can be fatal in healthy people in 24 to 48 hours.4 The right treatment depends on quick identification of the pathogen as bacterial, viral, or yeast.

Furthermore, patients with suspected meningitis are often treated empirically pending diagnostic results.5,6 This can mean lengthy hospitalizations and unnecessary antimicrobial use, all of which add to the overall cost of care.

BIOFIRE® FILMARRAY® Meningitis/Encephalitis (ME) Panel

The BIOFIRE ME Panel is a syndromic test that targets 14 of the most common bacterial, viral, and yeast causes of central nervous system infections. It takes just one small sample of 0.2 mL of cerebrospinal fluid (CSF) and about an hour to deliver accurate results.

The BIOFIRE ME Panel provides comprehensive results in a clinically actionable timeframe. Getting answers fast can be lifesaving and can help guide appropriate therapy. 

The BIOFIRE ME Panel has been shown to:

Increase diagnostic yield

  • 7x overall increase for adult patients7
  • 3x overall increase for pediatric patients8

Shorten time to diagnosis

  • 3-day reduction for adult patients9
  • 4-day reduction for pediatric patients6

Impact antimicrobial therapy

  • 2-day reduction in both acyclovir and antibiotic duration for adult patients10
  • 2-day reduction in both acyclovir and antibiotic duration for pediatric patients11

Shorten hospital stays

  • 2-day reduction in length of stay for adult patients10
  • 2-day reduction in length of stay for pediatric patients6

References

  1. Bacterial Meningitis. Accessed 7 Oct 2022. Retrieved from: https://www.cdc.gov/meningitis/bacterial.html#transmission
  2. Meningitis Research Foundation. Accessed 07 Oct 2022. Retrieved from: https://www.meningitis.org/blogs/the-history-of-meningitis
  3. CDC. Meningococcal Disease: Signs and Symptoms. Accessed 29 Nov 2022. Retrieved from: https://www.cdc.gov/meningococcal/about/symptoms.html
  4. Confederation of Meningitis Organisations. Meningitis Fact Sheet. Accessed 07 Oct 2022. Retrieved from: https://www.comomeningitis.org/facts.
  5. Bamberger D. Diagnosis, Initial Management, and Prevention of Meningitis. American Family Physician 2010 Dec 15;82:1491-1498.
  6. O'Brien M, et al. Impact of cerebrospinal fluid multiplex assay on diagnosis and outcomes of central nervous system infections in children: a before and after cohort study. The Pediatric Infectious Disease Journal 2018;37:868-71.
  7. Evans M, et al. Impact of the implementation of a rapid meningitis/encephalitis multiplex polymerase chain reaction panel on IV acyclovir duration: multicenter, retrospective cohort of adult and pediatric patients. Diagnostic Microbiology and Infectious Disease 2020;96(2):114935.
  8. Posnakoglou L, et al. Impact of cerebrospinal fluid syndromic testing in the management of children with suspected central nervous system infection. European Journal of Clinical Microbiology & Infectious Diseases Jul 2020.
  9. Cailleaux M, et al. Impact of a multiplex PCR assay (FilmArray®) on the management of patients with suspected central nervous system infections. European Journal of Clinical Microbiology & Infectious Diseases 2019;39(2):293-297.
  10. Moffa M, et al. Impact of a Multiplex Polymerase Chain Reaction Assay on the Clinical Management of Adults Undergoing a Lumbar Puncture for Suspected Community-Onset Central Nervous System Infections. Antibiotics (Basel) 2020;9(6):282.
  11. Hagen, A., Eichinger, A., Meryer-Buehn, M., Schober, T., & Huebner, J. (2020). Comparison of antibiotic and acyclovir usage before and after the implementation of an on-site FilmArray meningitis/encephalitis panel in an academic tertiary pediatric hospital: a retrospective observational study. BMC Pediatrics, 20(56).

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