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 diagnosedwith a first episode of cryptococcalmeningitis 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.