Impact of a Diagnostic Cerebrospinal Fluid Enterovirus Polymerase Chain Reaction Test on Patient Management

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Abstract
Aseptic meningitis is a common infection in the United States, with an estimated 75,000 cases each year.1,2 Approximately 80% to 92% of aseptic meningitis cases for which an etiologic agent is identified are caused by enteroviruses (EVs). Occurring mainly in the summer and fall, EV meningitis leads to a large number of hospitalizations of both children and adults.3,4 Although new antiviral agents are being developed specifically for EV meningitis, treatment is currently symptomatic, and the course of illness is usually benign.2 However, EV meningitis raises concern because of the difficulty in distinguishing it from bacterial meningitis based on clinical features alone. To distinguish the 2, hospitalization, empiric prescription of antimicrobial agents, and use of diagnostic testing are common. The ability to rapidly differentiate EV meningitis from bacterial illness has the potential for reduction of such health care services and cost savings. A definitive diagnosis is also prognostically useful in patients with central nervous system infection.