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, PCRSpecimen Type
VariesNecessary 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 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest 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.