Utility of FAME Panel inEstablishing the Etiology of Acute Encephalitis Syndrome

A new study assessed the utility of the Film Array Meningoencephalitis (FAME) panel in managing children with acute encephalitis syndrome (AES).

In this retrospective audit, conducted between 2017 and 2022, children under 18 years diagnosed with AES were included. All participants had undergone a cerebrospinal fluid (CSF) analysis – including FAME panel testing, performed within 48 hours of admission. Electronic medical records provided data on demographic profiles, clinical presentations, investigations, and outcomes. 

The results showed that out of the 157 CSF samples tested with the FAME panel, 49 (31.4%) were positive. Viral pathogens were detected in 42 cases – Enterovirus: 31, Human herpes virus 6: 9, Varicella zostervirus: 1, and Cytomegalovirus: 1. Bacterial pathogens in 6 cases – Streptococcus pneumoniae: 2, Streptococcus agalactiae: 2, Hemophilus influenzae: 1,and Escherichia coli: 1. Whereas, one child was diagnosed with a fungal etiology – Cryptococcus neoformans. Antibiotic therapy was discontinued within 72 hours for 42 children with identified viral etiologies, and acyclovir was stopped in 21 out of 32 children within the same timeframe after FAME panel testing. Four cases were presumed false positives. 

It was concluded that the FAME panel could establish the etiology of AES in nearly one-third of cases and effectively reduce the use of empirical antibiotic and antiviral therapies. With a positivity rate of 31.6%, the FAME panel proved to be a rapid diagnostic tool, aiding in earlier pathogen detection and more definitive diagnoses than conventional CSF testing. This facilitated timely treatment decisions and antimicrobial de-escalation within 72 hours, making the FAME panel a valuable addition to the diagnostic methods for evaluating children with AES.

Source: Thomas DT, Mohammed PK, Baby G, et al. Indian Pediatrics. 2024 May;61(5):452-5.