Ordering Recommendation

Molecular testing is preferred for patients presenting with meningitis/encephalitis. Refer to Meningitis/Encephalitis Panel by PCR (2013305).

New York DOH Approval Status

This test is not New York state approved. There are no New York state-approved laboratories available. Submit a Non-Permitted Laboratory Request Form (NPL) to the NYDOH prior to collection of specimen. If NPL is approved by NYDOH, and sample is received at ARUP, testing will be performed.

Specimen Required

Patient Preparation
Collect

CSF.

Specimen Preparation

Transfer 5.0mL CSF to an ARUP standard transport tube. (Min: 2.5mL)

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Serum or plasma. Contaminated, heat-inactivated, or hemolyzed specimens.

Remarks
Stability

Ambient: 8 hours; Refrigerated: 2 weeks; Frozen: 1 month

Methodology

Semi-Quantitative Enzyme-Linked Immunosorbent Assay (ELISA)/Semi-Quantitative Chemiluminescent Immunoassay (CLIA)

Performed

Sun-Sat

Reported

4-6 days

Reference Interval

Test Number
Components
Reference Interval
  West Nile Virus Antibody IgG CSF 1.29 IV or less
  West Nile Virus Antibody IgM CSF 0.89 IV or less
  HSV 1/2 Antibody Screen IgG, CSF 0.89 IV or less
  Measles, Rubeola, Antibody IgG CSF 16.4 AU/mL or less
  Measles, Rubeola, Antibody IgM CSF 0.79 AU or less
  Mumps Virus Antibody IgG CSF 10.9 AU/mL or less
  Mumps Virus Antibody IgM CSF 0.79 IV or less
  VZV Antibody IgM CSF 0.90 ISR or less
  VZV Antibody IgG CSF
<1.0 S/CO Negative - No significant level of IgG antibody to varicella-zoster virus detected.
>=1.0 S/CO Positive - IgG antibody to varicella-zoster virus detected, which may indicate a current or past varicella-zoster infection.

Interpretive Data




Component
Interpretation
Measles (Rubeola) Antibody, IgG, CSF 13.4 AU/mL or less:  Negative. No significant level of IgG antibody to measles (rubeola) virus detected.
13.5-16.4 AU/mL:  Equivocal. Repeat testing in 10-14 days may be helpful.
16.5 AU/mL or greater:  Positive. IgG antibody to measles (rubeola) detected, which may indicate a current or past measles (rubeola) infection.
Measles (Rubeola) Antibody, IgM, CSF 0.79 AU or less:  Negative. No significant level of IgM antibodies to measles (rubeola) virus detected.
0.80-1.20 AU:  Equivocal. Repeat testing in 10-14 days may be helpful.
1.21 AU or greater:  Positive. IgM antibodies to measles (rubeola) virus detected. Suggestive of current or recent infection or immunization. However, low levels of IgM antibodies may occasionally persist for more than 12 months post infection or immunization.
Mumps Virus Antibody IgG, CSF 8.9 AU/mL or less:  Negative. No significant level of detectable IgG mumps virus antibody.
9.0-10.9 AU/mL:  Equivocal. Repeat testing in 10-14 days may be helpful.
11.0 AU/mL or greater:  Positive. IgG antibody to mumps virus detected, which may indicate a current or past mumps virus infection.
Mumps Virus Antibody IgM, CSF 0.79 IV or less:  Negative. No significant level of detectable IgM antibody to mumps virus.
0.80-1.20 IV:  Equivocal. Borderline levels of IgM antibody to mumps virus. Repeat testing in 10-14 days may be helpful.
1.21 IV or greater:  Positive. Presence of IgM antibody to mumps virus detected, which may indicate a current or recent infection. However, low levels of IgM antibody may occasionally persist for more than 12 months post infection or immunization.
Varicella-Zoster Virus Antibody, IgG, CSF <1.0 S/CO: Negative. No significant level of IgG antibody to varicella-zoster virus detected.
>=1.0 S/CO: Positive. IgG antibody to varicella-zoster virus detected, which may indicate a current or past varicella-zoster infection.
Varicella-Zoster Virus Antibody, IgM by ELISA (CSF) 0.90 ISR or less:  Negative. No significant level of IgM antibody to varicella-zoster virus detected.
0.91-1.09 ISR:  Equivocal. Repeat testing in 10-14 days may be helpful.
1.10 ISR or greater:  Positive. Significant level of IgM antibody to varicella-zoster virus detected, which may indicate current or recent infection. However, low levels of IgM antibodies may occasionally persist for more than 12 months post infection.
Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgG, CSF 0.89 IV or less:  Negative. No significant level of detectable HSV IgG antibody.
0.90-1.09 IV:  Equivocal. Questionable presence of IgG antibodies. Repeat testing in 10-14 days may be helpful.
1.10 IV or greater:  Positive. IgG antibody to HSV detected which may indicate a current or past HSV infection.
West Nile Virus Antibody, IgG by ELISA, CSF 1.29 IV or less:  Negative. No significant level of West Nile virus IgG antibody detected.
1.30-1.49 IV:  Equivocal. Questionable presence of West Nile virus IgG antibody detected. Repeat testing in 10-14 days may be helpful.
1.50 IV or greater:  Positive. Presence of IgG antibody to West Nile virus detected, suggestive of current or past infection.
West Nile Virus Antibody, IgM by ELISA, CSF 0.89 IV or less:  Negative. No significant level of West Nile virus IgM antibody detected.
0.90-1.10 IV:  Equivocal. Questionable presence of West Nile virus IgM antibody detected. Repeat testing in 10-14 days may be helpful.
1.11 IV or greater:  Positive. Presence of IgM antibody to West Nile virus detected, suggestive of current or recent infection.

Compliance Category

Laboratory Developed Test (LDT)

Note

If HSV 1 and/or 2 IgG, CSF is 1.10 IV or greater, then HSV 1 G-specific IgG, CSF and HSV 2 G-specific IgG, CSF will be added. Additional charges apply.

Hotline History

N/A

CPT Codes

86765 x2; 86735 x2; 86787 x2; 86789; 86788; 86694; if reflexed, add 86695; 86696

Components

Component Test Code* Component Chart Name LOINC
0050238 West Nile Virus Antibody IgG CSF 39572-3
0050239 West Nile Virus Antibody IgM CSF 39573-1
0050394 HSV 1/2 Antibody Screen IgG, CSF 13249-8
0054440 Measles, Rubeola, Antibody IgG CSF 9566-1
0054441 Measles, Rubeola, Antibody IgM CSF 13283-7
0054442 Mumps Virus Antibody IgG CSF 13266-2
0054443 Mumps Virus Antibody IgM CSF 13267-0
0054444 VZV Antibody IgG CSF
0054445 VZV Antibody IgM CSF 31695-0
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

Encephalitis Panel With Reflex to Herpes Simplex Virus Types 1 and 2 Glycoprotein G-Specific Antibodies, IgG, CSF