Rapid diagnosis of bacterial meningitis using point-of-care PCR assay with negative cerebrospinal fluid culture

Meningitis due to Neisseria meningitidis can be challenging to diagnose due to reliance on cerebrospinal fluid (CSF) culture. CSF culture has variable diagnostic accuracy, requiring up to 48 hours to confirm bacterial growth and sensitivities. Point-of-care multiplex CSF PCR assays can provide a rapid diagnosis, confirming the presence of pathogenic genetic material from a panel within 1 hour. In this report, we describe a case of an adult teenage male with suspected bacterial meningitis, early disseminated intravascular coagulation and septicaemia. After 5 hours, a point-of-care CSF PCR test confirmed meningitis due to N. meningitidis infection. Although Gram-staining several hours later revealed Gram-negative cocci, his CSF culture was negative and delayed PCR testing at a remote facility confirmed the presence of N. meningitidis serogroup B.