Abstract
PURPOSE OF REVIEW: On World Encephalitis Day 19th February 2025, Encephalitis International launched the World Health Organization technical brief on encephalitis, highlighting the growing public health challenge and need for improved diagnostics. This review summarizes the published literature over the last 18 months on novel methods of identifying the aetiology of neurological infections and existing research gaps. RECENT FINDINGS: There is an increased availability and sensitivity of multiplex polymerase chain reaction assays and untargeted metagenomic sequencing in clinical practice. This is contributing to increasing diagnostic yield in suspected neurological infections. Preliminary results suggest that novel serological methods such as phage immunoprecipitation sequencing (Phip-seq) may be useful where molecular approaches are negative. SUMMARY: Significant progress in improving diagnostics has been made in the last decade. Going forward, multicentre studies and meta-analyses are needed to achieve adequate power in ascertaining the role of novel diagnostic methods in neurological infections. Studies need to investigate the impact on patient management and cost-effectiveness. The role of other omics methods in identifying host biomarkers for utilization in diagnostic algorithms needs further work.