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Test Code FLARP Free-Living Amebae, Molecular Detection, PCR, Varies

Useful For

Aids in the diagnosis of primary amebic meningoencephalitis and granulomatous amebic encephalitis in spinal fluid and tissue in conjunction with clinical and radiologic findings

 

This test should not be used to screen asymptomatic patients.

Method Name

Real-Time Polymerase Chain Reaction (PCR)/TaqMan DNA Probe Hybridization

Reporting Name

Free-living Amebae Detection, PCR

Specimen Type

Varies


Necessary Information


Specimen source is required.



Specimen Required


Submit only 1 of the following specimens:

 

Specimen Type: Spinal fluid

Container/Tube: Sterile container

Specimen Volume: 0.5 mL

Collection Instructions: Send vial number 2.

 

Specimen Type: Tissue: Fresh

Sources: Brain, skin, lung

Container/Tube: Sterile container

Specimen Volume: 5 to 10 mm

Collection Instructions: Submit tissue in a sterile container with 1 mL of sterile saline or minimal essential media (MEM).

 

Preferred: Paraffin-embedded tissue block:

Supplies: Tissue Block Container (T553)

Specimen Type: Formalin-fixed, paraffin-embedded tissue block (FFPE)

Sources: Brain, skin, lung

Container/Tube: Tissue block

Collection Instructions: Submit a FFPE tissue block to be cut and returned.

 

Acceptable: Paraffin-embedded tissue block:

Specimen Type: Formalin-fixed, paraffin-embedded tissue block (FFPE)

Sources: Brain, skin, lung

Container/Tube: Sterile container for each individual cut section (scroll).

Collection Instructions: Perform microtomy and prepare five separate 10-micron sections. Each section (scroll) must be placed in a separate sterile container for submission.


Specimen Minimum Volume

Spinal Fluid: 0.3 mL; Tissue: 5 mm biopsy

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Refrigerated (preferred) 7 days
  Frozen  7 days

Reference Values

Negative

Interpretation

A positive result indicates the presence of free-living amoeba DNA and is consistent with active or recent infection. While positive results are highly specific indicators of disease, they should be correlated with symptoms and clinical findings of primary amebic meningoencephalitis and granulomatous amebic encephalitis.

Clinical Reference

1. Cope JR, Ali KM, Visvesvara GS: Pathogenic and opportunistic free-living amebae. In: Carroll KC, Pfaller MA, Landry ML, et al, eds. Manual of Clinical Microbiology. 12th Ed. ASM Press; 2019:chap142

2. Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Foodborne, Waterborne, and Environmental Diseases (DFWED): Parasites - Acanthamoeba - Granulomatous Amebic Encephalitis (GAE); Keratitis. CDC; Updated December 29, 2021. Accessed March 28, 2023. Available at www.cdc.gov/parasites/acanthamoeba/health_professionals/acanthamoeba_keratitis_hcp.html

3 Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Foodborne, Waterborne, and Environmental Diseases (DFWED): Naegleria fowleri - Primary Amebic Meningoencephalitis (PAM) - Amebic Encephalitis. Updated July 7, 2022. Accessed February 19, 2023. Available at www.cdc.gov/parasites/naegleria/health_professionals.html

Day(s) Performed

Monday through Saturday

Report Available

2 to 3 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

87798 x 3

87999 (if appropriate for government payers)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
FLARP Free-living Amebae Detection, PCR 96910-5

 

Result ID Test Result Name Result LOINC Value
SSFLA Specimen Source 31208-2
38061 Acanthamoeba species PCR 41429-2
38062 Naegleria fowleri PCR 87758-9
38063 Balamuthia mandrillaris PCR 41432-6

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Testing Algorithm

For more information see Meningitis/Encephalitis Panel Algorithm.