Echovirus Antibodies, CSF

Test Code

37476

CPT Codes
86658 (x5)

Includes

Types 4, 7, 9, 11, 30

Preferred Specimen

2 mL CSF collected in a sterile, leak-proof container

Minimum Volume

1 mL

Transport Temperature

Room temperature

Specimen Stability

Room temperature: 7 days
Refrigerated: 14 days
Frozen: 30 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Gross hemolysis • Grossly icteric

Methodology
Complement Fixation (CF)

Setup Schedule

Set up: Tues-Sat; Report available: 1-5 days

Reference Range

Echovirus 4 Ab	<1:1 titer
Echovirus 7 Ab	<1:1 titer
Echovirus 9 Ab	<1:1 titer
Echovirus 11 Ab	<1:1 titer
Echovirus 30 Ab	<1:1 titer

Interpretive Criteria

<1:1	Antibody Not Detected
≥1:1	Antibody Detected

Clinical Significance

The test helps identify the presence of echovirus antibodies in the cerebrospinal fluid (CSF). The antibody panel includes echovirus 4, 7, 9, 11, and 30 and may be adjusted based on epidemiological data.

Echoviruses are nonpolio enteroviruses. Most people with echovirus infections are asymptomatic or exhibit mild upper respiratory symptoms. However, in rare cases, echovirus infection can lead to meningitis or encephalitis. Echovirus and coxsackieviruses are the most common pathogens causing aseptic meningitis [1].

Enterovirus PCR testing of CSF has been recommended for diagnosis of suspected encephalitis [2]. However, PCR testing does not identify the specific enteroviral type. Serum and CSF antibody testing (acute and convalescent) may provide additional information if the specific enterovirus type is needed for evaluation and could be especially helpful in outbreak settings [2,3]. Furthermore, if PCR results are negative, CSF antibody production may aid in the diagnosis.

Interpretation of results may be complicated by low antibodies levels found in CSF, passive transfer of antibodies from blood, and contamination via bloody taps.

The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.

References
1. Hasbun R, et al, Acute meningitis. In: Bennett JE, et al. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2019:1183-1219.
2. Solomon T, et al. J Infect. 2012;64(4):347-373.
3. American Academy of Pediatrics. Enteroviruses (non-poliovirus). In: Kimberlin DW, et al. 2015 Report of the Committee on Infectious Diseases. 30th ed. American Academy of Pediatrics; 2015:333-336.

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.