scholarly journals Metagenomic next-generation sequencing to diagnose atypical severe scrub typhus

2021 ◽  
Author(s):  
Zuan Zhan ◽  
Chun-fan Li ◽  
Jian Liu ◽  
Chun-shui Cao ◽  
Liang Huang
Keyword(s):  
Next Generation Sequencing ◽  
Scrub Typhus ◽  
Next Generation ◽  
Generation Sequencing

scholarly journals The Early Diagnosis of Scrub Typhus by Metagenomic Next-Generation Sequencing

2021 ◽  
Vol 9 ◽  
Author(s):  
Xianghong Liu ◽  
Ye Zhang ◽  
Jun Zhang ◽  
Zheng Lou ◽  
Han Xia ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Respiratory Tract ◽  
Scrub Typhus ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Febrile Illness ◽  
Diagnostic Methods ◽  
Chronic Obstructive ◽  
Next Generation ◽  
Generation Sequencing

Introduction: Scrub typhus is a mite-borne infection widespread in Southeast Asia, with clinical symptoms such as fever, chills, skin rash, eschar at the bite site, and other signs of acute febrile illness. The Rickettsia pathogen (Orientia tsutsugamushi) is always difficult to be diagnosed at an early stage by traditional clinical diagnostic methods, especially for patients without typical eschar. This greatly increases the mortality of patients with scrub typhus. A new approach should be introduced to improve its clinical diagnosis.Methods: During May 2018 to March 2021, 13 samples from 10 patients with suspected scrub typhus were collected. Metagenomic next-generation sequencing (mNGS) and other diagnostic methods (including serology using Weil–Felix reaction and indirect immunofluorescence test (IIFT) for scrub typhus and respiratory tract profile IgM as well as culture for routine bacteria) were used to identify the pathogens in this study.Results: The results of mNGS were all positive, with mapped reads of O. tsutsugamushi ranging from 1 to 460. Eight patients (80%) were diagnosed as scrub typhus. The other two were diagnosed as suspected scrub typhus due to the limited number of reads of the pathogen (one and two, respectively). According to clinical evidences, nine of the 10 patients were finally diagnosed as scrub typhus, except for patient 9 (suspected scrub typhus by mNGS with one specific reads of the pathogen) diagnosed as acute exacerbation of chronic obstructive pulmonary disease. For the five scrub typhus patients without typical eschar, mNGS gave all positive results (4–460 specific reads). For other methods, only Weil–Felix reaction of one patient detected the pathogen. In addition, the respiratory tract profile (IgM) detected various pathogens, but all were confirmed to be false positive.Conclusions: mNGS performed better than conventional clinical methods to early diagnose scrub typhus. This approach can be routinely carried out for early and precise diagnosis in clinical infections, especially for those hard to be identified by traditional diagnostic methods.

scholarly journals A Clinical Case of Scrub Typhus in the United States Forces Korea Patient with Eschar and Genetic Identification of Orientia tsutsugamushi Using Multiplex PCR-Based Next-Generation Sequencing

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 424
Author(s):  
Seungchan Cho ◽  
Jon C. Allison ◽  
Kkothanahreum Park ◽  
Jin Sun No ◽  
Seung-Ho Lee ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Multiplex Pcr ◽  
Scrub Typhus ◽  
Specific Antigen ◽  
Maculopapular Rash ◽  
The United States ◽  
Genetic Identification ◽  
Orientia Tsutsugamushi ◽  
Next Generation ◽  
Generation Sequencing

An epidemiological investigation was conducted for a scrub typhus case reported in a U.S. Forces Korea military patient in the Republic of Korea in November 2018. The patient had a fever, maculopapular rash, and an eschar. The full-length sequence of Orientia tsutsugamushi 56-kDa type-specific antigen (TSA) gene was obtained from eschar tissue by multiplex PCR-based Next Generation Sequencing for genetic identification. Based on the 56-kDa TSA gene, the O. tsutsugamushi aligned most closely with the Boryong strain.

scholarly journals Diagnosing scrub typhus without eschar: a case report using metagenomic next-generation sequencing (mNGS)

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Jie Li ◽  
Changwen Chen ◽  
Fangqiang Zou ◽  
Lin Liu ◽  
Baolong Wang ◽  
...  
Keyword(s):  
Case Report ◽  
Next Generation Sequencing ◽  
Scrub Typhus ◽  
Next Generation ◽  
Generation Sequencing

scholarly journals Acute Q Fever Diagnosed by Metagenomic Next-generation Sequencing and Clinically Compared With Scrub Typhus

2020 ◽  
Author(s):  
Xi Liu ◽  
Ziliang Lin ◽  
Hongqiong Zhu ◽  
Gongqi Chen ◽  
Pengyuan He ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Scrub Typhus ◽  
Q Fever ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Next Generation ◽  
Potential Threat ◽  
Significant Difference ◽  
Acute Q Fever ◽  
Generation Sequencing

Abstract Background: C. burnetti, the causative agent of Q fever, is considered a potential threat as a biological weapon because of highly infectious and pathogenic. There was an outbreak of Q fever in Zhuhai, P.R. China between December, 2018 and March 2019, although Zhuhai was not the endemic area of Q fever. 46 patients can be detected C. burnetti by metagenomic next-generation sequencing (mNGS). There are many similarities between acute Q fever and scrub typhus in clinical manifestations. Methods: We analyze the differences of clinical manifestations and serological between 46 patients with acute Q fever and 100 patients with scrub typhus. The general information of patients including gender, age, basic disease, days from disease onset and clinical manifestations were evaluated. Results: Their mean age of acute Q fever was 43.6±11.8 (ranging from 32 to 55 years old), younger than scrub typhus patients (53.9±12.7, ranging from 41 to 67 years old) (P<0.001). Males are more susceptible to C. burnetti. There were 45 males (97.8%) in acute Q fever patients and 59 males (59.0%) in scrub typhus patients (P<0.001). Compared with scrub typhus, patients with acute Q fever are more prone to present sore throat (P=0.003), abnormal liver function (P<0.001) and elevated levels of procalcitonin (P<0.001). Meanwhile, skin rash (P<0.001), eschar (P<0.001), lymphadenopathy (P<0.001), leukocytosis (P<0.001), thrombocytopenia (P=0.003), eosinophils reducing or disappearing (P=0.002) and pulmonary involvement on chest imaging (P=0.003) were more common in scrub typhus. There was significant difference between the two groups (P<0.001). Days from minocycline treatment to defervescence in acute Q fever (1.82±1.357, ranging from 0.5 to 3.2 days) were shorter than scrub typhus (2.85±2.801, ranging from 0.0 to 5.7 days) (P=0.008). Conclusions: mNGS is helpful to early diagnosis of acute Q fever. Sex, age, serologic test and physical examination are important in the differentiation of acute Q fever from scrub typhus in Zhuhai, China.

Labordiagnostik bei gastrointestinalen Tumoren

2020 ◽  
Vol 11 (05) ◽  
pp. 232-238
Author(s):  
Marcus Kleber
Keyword(s):  
Next Generation Sequencing ◽  
Kolorektales Karzinom ◽  
Next Generation ◽  
Generation Sequencing

ZUSAMMENFASSUNGDas kolorektale Karzinom (KRK) ist einer der häufigsten malignen Tumoren in Deutschland. Einer frühzeitigen Diagnostik kommt große Bedeutung zu. Goldstandard ist hier die Koloskopie. Die aktuelle S3-Leitlinie Kolorektales Karzinom empfiehlt zum KRK-Screening den fäkalen okkulten Bluttest. Für das Monitoring von Patienten vor und nach Tumorresektion werden die Messung des Carcinoembryonalen Antigens (CEA) und der Mikrosatellitenstabilität empfohlen. Für die Auswahl der korrekten Chemotherapie scheint derzeit eine Überprüfung des Mutationsstatus, mindestens des KRAS-Gens und des BRAF-Gens, sinnvoll zu sein. Eine Reihe an neuartigen Tumormarkern befindet sich momentan in der Entwicklung, hat jedoch noch nicht die Reife für eine mögliche Anwendung in der Routinediagnostik erreicht. Den schnellsten Weg in die breite Anwendung können Next-Generation-Sequencing-basierte genetische Tests finden.

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