Khetsuriani N, Holman RC, Anderson LJ. Burden of encephalitis-associated hospitalizations in the United States, 1988-1997. Clin Infect Dis. 2002;35:175-182. Abstract
George P, Schneider EB, Venkatesan A. Encephalitis hospitalization rates and inpatient mortality in the United States, 2000-2010. PLoS One. 2014;9:e104169.
Centers for Disease Control and Prevention. Enhanced Meningococcal Disease Surveillance Report, 2015. https://www.cdc.gov/meningococcal/downloads/NCIRD-EMS-Report.pdf. June 2017. Accessed July 11, 2017.
National Meningitis Association. Statistics and disease facts. http://www.nmaus.org/disease-prevention-information/statistics-and-disease-facts/. Accessed July 11, 2017.
Xpert® EV. Cepheid. http://www.cepheid.com/us/cepheid-solutions/clinical-ivd-tests/critical-infectious-diseases/xpert-ev. Accessed July 11, 2017.
Simplexa™ HSV 1 & 2 Direct Kit. DiaSorin. https://www.focusdx.com/product/MOL2150/ous. Accessed July 11, 2017.
FilmArray® Meningitis/Encephalitis Panel. BioFire. http://www.biofiredx.com/wp-content/uploads/2016/03/IS-MRKT-PRT-0297-03-FilmArray-MeningitisEncephalitis-Panel-Information-Sheet.pdf. Accessed July 11, 2017.
Bonadio W. Pediatric lumbar puncture and cerebrospinal fluid analysis. J Emerg Med. 2014;46:141-150. Abstract
Wallace SS, Lopez MA, Caviness AC. Impact of enterovirus testing on resource use in febrile young infants: a systematic review. Hosp Pediatr. 2017;7:96-102. Abstract
Rao S, Abzug MJ, Carosone-Link P. Intravenous acyclovir and renal dysfunction in children: a matched case control study. J Pediatr. 2015;166:1462-1468. Abstract
Gaensbauer JT, Birkholz M, Pfaffenstein K, et al. Herpes PCR testing and empiric acyclovir use beyond the neonatal period. Pediatrics. 2014;134:e651-656. Abstract
Messacar K, Breazeale G, Robinson CC, et al. Potential clinical impact of the film array meningitis encephalitis panel in children with suspected central nervous system infections. Diagn Microbiol Infect Dis. 2016;86:118-120. Abstract
Gomez CA, Pinsky BA, Liu A, et al. Delayed diagnosis of tuberculous meningitis misdiagnosed as herpes simplex virus-1 encephalitis with the FilmArray syndromic polymerase chain reaction panel. Open Forum Infect Dis. 2016;4:ofw245.
Leber AL, Everhart K, Balada-Llasat J-M, et al. Multicenter evaluation of BioFire FilmArray Meningitis/Encephalitis Panel for detection of bacteria, viruses, and yeast in cerebrospinal fluid specimens. J Clin Microbiol. 2016;54:2251-2261. Abstract
Greenberg RG, Smith PB, Cotton CM, et al. Traumatic lumbar punctures in neonates: test performance of the cerebrospinal fluid white blood cell count. Pediatric Infect Dis J. 2008;27:1047-1051.

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Moderator(s)

Kenneth A. Alexander, MD, PhD

Professor of Pediatrics, The University of Central Florida College of Medicine, Chief, Division of Allergy, Immunology, Rheumatology and Infectious Diseases, Nemours Children's Hospital, Orlando, Florida

Disclosures

Disclosure: Kenneth A. Alexander, MD, PhD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Merck & Co., Inc.; MSD
Served as a speaker or a member of a speakers bureau for: Merck & Co., Inc.; MSD

Dr Alexander does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Alexander does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Panelists

Kevin B. Messacar, MD

Assistant Professor, University of Colorado, School of Medicine, Aurora, Colorado

Disclosures

Disclosure: Kevin B Messacar, MD, has disclosed no relevant financial relationships.

Dr Messacar does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Messacar does intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Amy L. Leber, PhD

Associate Professor – Clinical, Departments of Pathology and Laboratory Medicine and Pediatrics, Ohio State University College of Medicine; Director, Clinical Microbiology and Immunoserology, Nationwide Children’s Hospital, Columbus, Ohio

Disclosures

Disclosure: Amy L. Leber, PhD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: BioFire Diagnostics
Served as a speaker or a member of a speakers bureau for: BioFire Diagnostics; Hologic, Inc
Received grants for clinical research from: BioFire Diagnostics; Cepheid Inc; DiaSorin; Hologic, Inc; Luminex Corporation

Dr Leber does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Leber does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Editors

Julia Muino, MA

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Julia Muino, MA, has disclosed no relevant financial relationships.

Heather Lewin, MA

Associate Scientific Director, Medscape, LLC

Disclosures

Disclosure: Heather Lewin has disclosed no relevant financial relationships.

Susan L. Smith, MN, PhD

Lead Scientific Director, Medscape, LLC

Disclosures

Disclosure: Susan L. Smith, MN, PhD, has disclosed no relevant financial relationships.

CME Reviewer(s)

Robert Morris, PharmD

Associate CME Clinical Director, Medscape, LLC

Disclosures

Disclosure: Robert Morris, PharmD, has disclosed no relevant financial relationships.

CME / ABIM MOC

When Minutes Count: Timely Diagnosis in Meningitis and Encephalitis

Authors: Kenneth A. Alexander, MD, PhD; Amy L. Leber, PhD; Kevin B. Messacar, MD
CME / ABIM MOC Released: 8/2/2017; Reviewed and Renewed: 5/13/2019
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 5/13/2020, 11:59 PM EST

Start Activity

Target Audience and Goal Statement

This activity is intended for emergency medicine physicians, infectious disease specialists, intensivists, and pediatricians.

The goals of this activity are to increase awareness of newer molecular diagnostic methods for meningitis and of the role of these methods in clinical decision-making.

Upon completion of this activity, participants will:

Have increased knowledge regarding the key distinguishing characteristics among laboratory methods for the diagnosis of meningitis and encephalitis
Have greater competence related to the clinical implications of rapid molecular diagnostics for meningitis and encephalitis
Demonstrate greater confidence in their ability to identify key attributes of molecular methodologies, such as multiplex polymerase chain reaction, in the diagnosis of meningitis and encephalitis

Disclosures

Moderator(s)

Kenneth A. Alexander, MD, PhD

Professor of Pediatrics, The University of Central Florida College of Medicine, Chief, Division of Allergy, Immunology, Rheumatology and Infectious Diseases, Nemours Children's Hospital, Orlando, Florida

Disclosures

Disclosure: Kenneth A. Alexander, MD, PhD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Merck & Co., Inc.; MSD
Served as a speaker or a member of a speakers bureau for: Merck & Co., Inc.; MSD

Dr Alexander does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Alexander does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Panelists

Kevin B. Messacar, MD

Assistant Professor, University of Colorado, School of Medicine, Aurora, Colorado

Disclosures

Disclosure: Kevin B Messacar, MD, has disclosed no relevant financial relationships.

Dr Messacar does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Messacar does intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Amy L. Leber, PhD

Associate Professor – Clinical, Departments of Pathology and Laboratory Medicine and Pediatrics, Ohio State University College of Medicine; Director, Clinical Microbiology and Immunoserology, Nationwide Children’s Hospital, Columbus, Ohio

Disclosures

Disclosure: Amy L. Leber, PhD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: BioFire Diagnostics
Served as a speaker or a member of a speakers bureau for: BioFire Diagnostics; Hologic, Inc
Received grants for clinical research from: BioFire Diagnostics; Cepheid Inc; DiaSorin; Hologic, Inc; Luminex Corporation

Dr Leber does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Leber does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Editors

Julia Muino, MA

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Julia Muino, MA, has disclosed no relevant financial relationships.

Heather Lewin, MA

Associate Scientific Director, Medscape, LLC

Disclosures

Disclosure: Heather Lewin has disclosed no relevant financial relationships.

Susan L. Smith, MN, PhD

Lead Scientific Director, Medscape, LLC

Disclosures

Disclosure: Susan L. Smith, MN, PhD, has disclosed no relevant financial relationships.

CME Reviewer(s)

Robert Morris, PharmD

Associate CME Clinical Director, Medscape, LLC

Disclosures

Disclosure: Robert Morris, PharmD, has disclosed no relevant financial relationships.

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Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.50 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Aggregate participant data will be shared with commercial supporters of this activity.

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From Medscape Education Infectious Diseases

CME / ABIM MOC

When Minutes Count: Timely Diagnosis in Meningitis and Encephalitis

Authors: Kenneth A. Alexander, MD, PhD; Amy L. Leber, PhD; Kevin B. Messacar, MDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME / ABIM MOC Released: 8/2/2017; Reviewed and Renewed: 5/13/2019

Valid for credit through: 5/13/2020, 11:59 PM EST

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The educational activity presented above may involve simulated case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient is intended or should be inferred.

The material presented here does not necessarily reflect the views of Medscape, LLC, or companies that support educational programming on medscape.org. These materials may discuss therapeutic products that have not been approved by the US Food and Drug Administration and off-label uses of approved products. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or employing any therapies described in this educational activity.

References

Faculty and Disclosures

Moderator(s)

Kenneth A. Alexander, MD, PhD

Panelists

Kevin B. Messacar, MD

Amy L. Leber, PhD

Editors

Julia Muino, MA

Heather Lewin, MA

Susan L. Smith, MN, PhD

CME Reviewer(s)

Robert Morris, PharmD

CME / ABIM MOC

When Minutes Count: Timely Diagnosis in Meningitis and Encephalitis

Target Audience and Goal Statement

Disclosures

Moderator(s)

Kenneth A. Alexander, MD, PhD

Panelists

Kevin B. Messacar, MD

Amy L. Leber, PhD

Editors

Julia Muino, MA

Heather Lewin, MA

Susan L. Smith, MN, PhD

CME Reviewer(s)

Robert Morris, PharmD

Accreditation Statements

For Physicians

Instructions for Participation and Credit

When Minutes Count: Timely Diagnosis in Meningitis and Encephalitis