Detection of Listeria monocytogenes in a patient with meningoencephalitis using next-generation sequencing: a case report

Abstract Background Listeria monocytogenes (L. monocytogenes) is a facultative intracellular bacterial pathogen which can invade different mammalian cells and reach to the central nervous system (CNS), leading to meningoencephalitis and brain abscesses. In the diagnosis of L. monocytogenes meningoencephalitis (LMM), the traditional test often reports negative owing to the antibiotic treatment or a low number of bacteria in the cerebrospinal fluid. To date, timely diagnosis and accurate treatment remains a challenge for patients with listeria infections. Case presentation We present the case of a 66-year-old woman whose clinical manifestations were suspected as tuberculous meningoencephalitis, but the case was finally properly diagnosed as LMM by next-generation sequencing (NGS). The patient was successfully treated using a combined antibacterial therapy, comprising ampicillin and trimethoprim-sulfamethoxazole. Conclusion To improve the sensitivity of LMM diagnosis, we used NGS for the detection of L. monocytogenes. Hence, the clinical utility of this approach can be very helpful since it provides quickly and trust results.

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Next-Generation Sequencing Analysis of Root Canal Microbiota Associated with a Severe Endodontic-Periodontal Lesion

Diagnostics ◽

10.3390/diagnostics11081461 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1461

Author(s):

Alessio Buonavoglia ◽

Gianvito Lanave ◽

Michele Camero ◽

Marialaura Corrente ◽

Antonio Parisi ◽

...

Keyword(s):

Next Generation Sequencing ◽

Bacterial Population ◽

Clinical Manifestations ◽

Fusobacterium Nucleatum ◽

Sequencing Analysis ◽

Next Generation ◽

Bacterial Migration ◽

Next Generation Sequencing Analysis ◽

Next Generation Sequencing Ngs ◽

Generation Sequencing

A patient with an unusual endo-periodontal lesion, without coronal decay or damage, likely caused by a deep periodontal lesion with subsequent endodontic bacterial migration, required medical care. Next-generation sequencing (NGS) was used to assess the endodontic microbiota in vestibular and palatal canals after tooth extraction, evidencing a predominant population (Fusobacterium nucleatum) in one endodontic canal, and a mixed bacterial population with six major populations almost equally distributed in the other endodontic canal (F. nucleatum, Porphyromonas gingivalis, P. endodontis, Parvimonas, Peptostreptococcus stomatis, Prevotella multiformis). These data could suggest different, separated ecologic niches in the same endodontic system, with potentially different pathogenicity levels, clinical manifestations and prognoses for every single canal of the same tooth.

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Case Report: A Candida Meningitis in an Immunocompetent Patient Detected Through the Next-Generation Sequencing

Frontiers in Medicine ◽

10.3389/fmed.2021.656066 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xiao-guang Cao ◽

Chuang-wei Yu ◽

Shu-sheng Zhou ◽

Yu Huang ◽

Chun-yan Wang

Keyword(s):

Next Generation Sequencing ◽

Fungal Infections ◽

Treatment Plan ◽

Immunocompetent Patient ◽

Cns Infection ◽

Next Generation ◽

Csf Analysis ◽

The Central Nervous System ◽

Next Generation Sequencing Ngs ◽

Generation Sequencing

Background: Fungal infections of the central nervous system (CNS) are not commonly seen clinically. Clinical diagnosis of fungal infections often depend on the pathogen culture and the clinical features. This method is time-consuming and insensitive, which can lead to misdiagnosis. The authors introduce an adult patient with fungal infections diagnosed by next-generation sequencing (NGS).Case: The patient was a 60-year-old male Chinese who had both hypermyotonia of the lower extremities and fever. The auxiliary examinations such as MRI, CT, and cerebrospinal fluid (CSF) analysis showed obvious abnormalities. Because of the difficulties in diagnosis, it was hard to determine the treatment plan. The NGS detected specific sequences of Candida albicans in 3 days. The patient was then treated with liposomal amphotericin B and fluconazole. About 3 weeks later, the symptoms of the patient improved significantly and he was discharged from the hospital.Conclusion: Compared with the routine cultural method, NGS has made a huge advancement in infection diagnosis and targeting antimicrobial therapy for CNS infection.

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Next generation sequencing panel in undifferentiated autoinflammatory diseases identifies patients with colchicine-responder recurrent fevers

Rheumatology ◽

10.1093/rheumatology/kez270 ◽

2019 ◽

Vol 59 (2) ◽

pp. 344-360 ◽

Cited By ~ 7

Author(s):

Riccardo Papa ◽

Marta Rusmini ◽

Stefano Volpi ◽

Roberta Caorsi ◽

Paolo Picco ◽

...

Keyword(s):

Next Generation Sequencing ◽

Clinical Manifestations ◽

Final Diagnosis ◽

Chronic Inflammatory Disease ◽

Autoinflammatory Diseases ◽

Molecular Diagnostic ◽

Recurrent Fever ◽

Next Generation ◽

Next Generation Sequencing Ngs ◽

Generation Sequencing

Abstract Objectives The number of innate immune system disorders classified as systemic autoinflammatory diseases (SAID) has increased in recent years. More than 70% of patients with clinical manifestations of SAID did not receive a molecular diagnosis, thus being classed as so-called undifferentiated or undefined SAID (uSAID). The aim of the present study was to evaluate a next-generation sequencing (NGS)-based clinically oriented protocol in patients with uSAID. Methods We designed a NGS panel that included 41 genes clustered in seven subpanels. Patients with uSAID were classified into different groups according to their clinical features and sequenced for the coding portions of the 41 genes. Results Fifty patients were enrolled in the study. Thirty-four patients (72%) displayed recurrent fevers not consistent with a PFAPA phenotype. Sixteen patients displayed a chronic inflammatory disease course. A total of 100 gene variants were found (mean 2 per patient; range 0–6), a quarter of which affected suspected genes. Mutations with a definitive diagnostic impact were detected in two patients. Patients with genetically negative recurrent fevers displayed a prevalent gastrointestinal, skin and articular involvement. Patients responded to steroids on demands (94%) and colchicine, with a response rate of 78%. Conclusion Even with a low molecular diagnostic rate, a NGS-based approach is able to provide a final diagnosis in a proportion of uSAID patients with evident cost-effectiveness. It also allows the identification of a subgroup of genetically negative patients with recurrent fever responding to steroid on demand and colchicine.

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The metagenomic next-generation sequencing in diagnosing central nervous system angiostrongyliasis: a case report

BMC Infectious Diseases ◽

10.1186/s12879-020-05410-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Li Feng ◽

Aiwu Zhang ◽

Jiali Que ◽

Hongyan Zhou ◽

Haiyan Wang ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Next Generation Sequencing ◽

Clinical Manifestations ◽

Next Generation ◽

Opening Pressure ◽

Csf Analysis ◽

Elevated Protein ◽

The Central Nervous System ◽

Generation Sequencing

Abstract Backgrounds The incidence of angiostrongyliasis is increasing in recent decades due to the expanding endemic areas all over the world. Clinicians face tremendous challenge of diagnosing angiostrongyliasis because of the lack of awareness of the disease and less effective definitive laboratory tests. Case presentation A 27-year-old man initially manifested skin itching, emesis, myalgia and quadriparesis. With progressive weakness of four limbs and elevated protein in the cerebrospinal fluid (CSF), he was diagnosed as Guillain-Barré syndrome and treated with intravenous methylprednisolone and immunoglobulin. However, the patient deteriorated with hyperpyrexia, headache and then persistent coma. The routine tests for Angiostrongylus cantonensis (A. cantonensis) with both the CSF and the serum were all negative. In contrast, the metagenomic next-generation sequencing (mNGS) was applied with the serum sample and the CSF sample in the middle phase. The central nervous system (CNS) angiostrongyliasis was diagnosed by mNGS with the mid-phase CSF, but not the mid-phase serum. At the same time, the CSF analysis revealed eosinophils ratio up to 67%. The discovery of A. cantonensis was confirmed by PCR with CSF later. Unfortunately, the patient died of severe angiostrongyliasis. During his hospitalization, mNGS was carried out repeatedly after definitive diagnosis and targeted treatment. The DNA strictly map reads number of A. cantonensis detected by mNGS was positively correlated with the CSF opening pressure and clinical manifestations. Conclusions The case of A. cantonensis infection highlights the benefit of mNGS as a target-free identification in disclosing the rare CNS angiostrongyliasis in the unusual season, while solid evidence from routine clinical testing was absent. The appropriate sample of mNGS should be chosen according to the life cycle of A. cantonensis. Besides, given the fact that the DNA reads number of A. cantonensis fluctuated with CSF opening pressure and clinical manifestations, whether mNGS could be applied as a marker of effectiveness of treatment is worth further exploration.

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Metagenomic Next-Generation Sequencing Can Clinch Diagnosis of Non-Tuberculous Mycobacterial Infections: A Case Report

Frontiers in Medicine ◽

10.3389/fmed.2021.679755 ◽

2021 ◽

Vol 8 ◽

Author(s):

He Zhu ◽

Min Zhu ◽

Jia-Hui Lei ◽

Ya-Li Xiao ◽

Li-Min Zhao

Keyword(s):

Next Generation Sequencing ◽

Mycobacterium Avium Complex ◽

Clinical Manifestations ◽

Lung Infection ◽

Diagnosis And Treatment ◽

Recurrent Fever ◽

Pathogenic Microorganism ◽

Next Generation ◽

Accurate Treatment ◽

Generation Sequencing

Non-tuberculou Mycobacteria (NTM) is ubiquitous in the environment and is conditional pathogen. Due to NTM and Mycobacterium tuberculosis belong to the genus Mycobacterium, their pathogenic mechanisms and clinical manifestations are similar. Therefore, NTM can cause tuberculosis-like lesions and lead to misdiagnosis. Early diagnosis and treatment greatly improve prognosis. However, traditional pathogenic microorganism detection has limitations, and it is difficult to accurately identify strains in clinical practice. Here, we report a 65-year-old man with NTM who presented with recurrent fever and cough. Computed tomography of the chest revealed a lung infection. The previous improper diagnosis and treatment did not improve his condition. With the aid of metagenomic next-generation sequencing, the pathogen was identified as Mycobacterium avium complex. Subsequently, he received accurate treatment and made significant improvements in clinical and radiology.

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