Case Report: Metagenomic Next-Generation Sequencing Confirmed a Case of Central Nervous System Infection With Brucella melitensis in Non-endemic Areas

Cao, Jun; Cai, Qingqing; Su, Wentao; Ge, Zi; Zhao, Hui; Zhou, Xinjian; Ma, Ke; Xia, Zhi‐Jie

doi:10.3389/fmed.2021.723197

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…Furthermore, CSF macrogenome sequencing has been reported to be a helpful tool for diagnosing NB, especially when routine infectious disease examination shows no signi cant abnormalities. This provides a new approach to the diagnosis of NB [29,30] and a powerful method for differentiating NB from tuberculous meningitis [31].…”

Section: Discussionmentioning

confidence: 99%

Characterization of 38 cases of Neurobrucellosis

Qi,

Niu,

Ren

et al. 2024

Preprint

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Aim：In this study, we thoroughly examine and discuss the clinical features, laboratory findings, treatment, and recovery of 38 neurobrucellosis cases. Additionally, we provide insights into the most recent research advances in the field of neurobrucellosis. Materials and methods：In this study, we collected general data, clinical characteristics, ancillary tests, and treatment plans of 38 cases of neurobrucellosis diagnosed and treated at the General Hospital of Ningxia Medical University from March 2012 to December 2022. Results：Among the 38 cases, 25 were male, and 23 had a clear history of cattle and sheep exposure. The most common clinical manifestations were fever (81.58%) and headache (76.32%). Brucella agglutination test was positive in 37 patients, and 37 patients showed increased protein in the cerebrospinal fluid. All 38 patients had a complete blood routine, with 11 cases showing abnormal white blood cell counts. Among the 29 patients who underwent cranial magnetic resonance imaging, 12 showed abnormalities. There were no in-hospital deaths among the patients. Conclusions：Neurobrucellosis exhibits diverse clinical manifestations and can be difficult to differentiate from tuberculous meningitis. Routine tests such as complete blood routine and cranial magnetic resonance imaging have limited diagnostic value for neurobrucellosis and are prone to clinical misdiagnosis and underdiagnosis. Patients with a history of contact with cattle and sheep in nearby grazing areas and presenting with symptoms such as fever and headache should undergo laboratory tests such as Brucella agglutination test or cerebrospinal fluid culture to establish an early and accurate diagnosis. Prompt initiation of treatment with doxycycline, rifampin, and ceftriaxone sodium triple therapy against Brucellosis is crucial in areas close to pastoral regions with potential cattle and sheep exposure.

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Section: Discussionmentioning

confidence: 99%

Characterization of 38 cases of Neurobrucellosis

Qi,

Niu,

Ren

et al. 2024

Preprint

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“…As a new detection method, mNGS does not rely on traditional microbial culture and directly performs high-throughput sequencing of nucleic acids in samples. It can quickly and indiscriminately detect pathogenic microorganisms in samples (Salzberg et al, 2016 ; Gu et al, 2019 ; Wilson et al, 2019 ), such as bacteria, viruses, fungi, and parasites, to the difficult infections or rare pathogenic microorganisms especially (Fan et al, 2020 ; Cao et al, 2021 ; Liu et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Detection of Japanese Encephalitis by Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid: A Case Report and Literature Review

et al. 2022

Front. Cell. Neurosci.

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Japanese encephalitis (JE) is an acute viral central nervous system disease, although less than 1% of patients infected with Japanese encephalitis virus (JEV) result in JE, which has an extremely poor prognosis. The Routine detection methods for JEV are time-consuming or limited by hospital conditions, therefore, need the quicker and sensitive techniques to detect JEV. Here, we reported a 14-year-old female who was admitted to our hospital with a severe fever, progressively headache and unconsciousness. Based on the clinical presentation, Preliminary diagnosis on admission indicated central nervous system infection of suspected viral meningoencephalitis or autoimmune encephalitis. The patient's symptoms were unrelieved after being treated with empiric antiviral therapy. Magnetic resonance imaging (MRI) showed that the lesions were located in the bilateral thalamus, head of caudate nucleus, and right lenticular nucleus, so we had to consider the possibility of Flaviviruses infection. We sent the cerebrospinal fluid (CSF) for metagenomic next-generation sequencing (mNGS) immediately, subsequent result suggested the infection caused by JEV. Two days later the results of the serum agglutination test confirmed that virus immunoglobulin M antibody positive. After a week treatment with intravenous immunoglobulin (IVIG), meanwhile, the lumbar puncture was used to check the pressure and various indicators of the CSF again to evaluate the treatment effect, An decrease in the number of WBC indicates, protein and unique RNA reads that the previous experimental treatment was effective, accompany by temperature and consciousness of the patient was normalized. Two weeks after admission, the patient was transferred to the rehabilitation hospital, MR showed the lesions had disappeared completely after 2 months of follow-up. We believed that mNGS may be an effective method for rapid identification of JE.

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“…Interpretation of mNGS results demands further validation by a large number of clinical trials. Present study relevant to clinical application and impact has mostly limited to case reports or small-scale cohort studies (9)(10)(11)(12)(13)(14)(15), most of which have focused on pathogen detection from single type of sample. To bridge this research gap, we performed a multi-type retrospective study to assess the clinical e cacy and value of mNGS test for rapid pathogen detection in patients with suspected infectious diseases, explore its application in clinical microbiology and considerations for implementation of mNGS in a clinical laboratory.…”

Section: Introductionmentioning

confidence: 99%