scholarly journals Elizabethkingia miricola Causes Intracranial Infection: A Case Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Hongguang Gao ◽  
Tian Li ◽  
Li Feng ◽  
Shu Zhang
Keyword(s):  
Cerebrospinal Fluid ◽  
Adult Patient ◽  
Early Identification ◽  
Acute Onset ◽  
Resistant Organism ◽  
Emergency Setting ◽  
Intracranial Infection ◽  
Second Generation Sequencing ◽  
Tract Infections ◽  
Generation Sequencing

Background:Elizabethkingia miricola is a rarely encountered bacterium in clinical practice. It is a rare gram-negative rod-shaped bacterium associated with lung and urinary tract infections, but never found in cerebrospinal fluid. This paper reports a case of an adult patient infected by E. miricola via an unknown route of infection causing a severe intracranial infection. Elizabethkingia miricola was detected by culture and Metagenomic next generation sequencing in CSF. Early identification of this strain and treatment with sensitive antibiotics is necessary to reduce morbidity and mortality.Case Report: A 24-year-old male was admitted to a West China Hospital because of headache and vomiting for 2 months. Symptom features included acute onset and long duration of illness. Notably, headache and vomiting were the primary neurological symptoms. Routine cerebrospinal fluid culture failed to identify the bacterium; however, Elizabethkingia miricola bacterium was detected via second-generation sequencing techniques. Elizabethkingia miricola was found to be a multi-drug resistant organism, hence, treatment with ceftriaxone, a commonly used drug for intracranial infections was ineffective. This strain eventually caused severe intracranial infection resulting in the death of the patient.Conclusion: In summary, this study comprehensively describes a case of an adult patient infected by E. miricola and discusses its early identification as well as application of sensitive antibiotics in the emergency setting.

scholarly journals A case report of the differential diagnosis of Cellulosimicrobium cellulans-infected endocarditis combined with intracranial infection by conventional blood culture and second-generation sequencing

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Huifang Zhang ◽  
Chunyan He ◽  
Rui Tian ◽  
Ruilan Wang
Keyword(s):  
Second Generation ◽  
Human Infection ◽  
Sequencing Data ◽  
Case Presentation ◽  
Intracranial Infection ◽  
Cellulosimicrobium Cellulans ◽  
Two Samples ◽  
Second Generation Sequencing ◽  
Generation Sequencing

Abstract Background Cellulosimicrobium cellulans is a gram-positive filamentous bacterium found primarily in soil and sewage that rarely causes human infection, especially in previously healthy adults, but when it does, it often indicates a poor prognosis. Case presentation We report a case of endocarditis and intracranial infection caused by C. cellulans in a 52-year-old woman with normal immune function and no implants in vivo. The patient started with a febrile headache that progressed to impaired consciousness after 20 days, and she finally died after treatment with vancomycin combined with rifampicin. C. cellulans was isolated from her blood cultures for 3 consecutive days after her admission; however, there was only evidence of C. cellulans sequences for two samples in the second-generation sequencing data generated from her peripheral blood, which were ignored by the technicians. No C. cellulans bands were detected in her cerebrospinal fluid by second-generation sequencing. Conclusions Second-generation sequencing seems to have limitations for certain specific strains of bacteria.

scholarly journals Next-generation Sequencing with cerebrospinal fluid for the diagnosis of progressive multifocal leukoencephalopathy in HIV-infected patients

2019 ◽  
Author(s):  
Renfang Zhang ◽  
Tangkai Qi ◽  
Jun Chen ◽  
Jianjun Sun ◽  
Li Liu ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Cell Count ◽  
Antiretroviral Treatment ◽  
Second Generation ◽  
Clinical Manifestations ◽  
White Matter Lesions ◽  
Blood Cell Count ◽  
Second Generation Sequencing ◽  
Generation Sequencing ◽  
Cd4 T Cell Count

Abstract Background To investigate the clinical manifestations, imaging findings, characteristics of cerebrospinal fluid, treatment and prognosis in patients with AIDS-related progressive white matter lesions diagnosed by second-generation sequencing with cerebrospinal fluid.Methods Patients with clinically suspected PML were diagnosed by second-generation sequencing with cerebrospinal fluid, and the clinical data of these patients were retrospectively reviewed.Results Ten patients with AIDS-related PML were diagnosed, including eight males (80%). The average age was 38.7±8.2 years, and the median CD4+ T cell count was 46×106/L. The median HIV RNA was 5.99 × 104 copies/ml. Main clinical manifestations included: dyskinesia in 4 patients (40%) and dizziness in 3(30%), cognitive decline in 2(20%), and speech disorder in 1(10%). Three patients (30%) developed convulsions throughout the course of the disease. Image findings involved lesions cerebellum in 3 cases (30%), and lesions above the cerebellum in 7 cases (70%). Mild increase of total protein was observed in the cerebrospinal fluid of 4 cases (40%), while white blood cell count, sugar and chloride were normal in all of the cases. The copies of JCV sequence in the cerebrospinal fluid ranged from 3-12531 reads (median=67 reads). All the patients received antiviral therapy including integrase inhibitors. Among the 10 patients, 2 died in hospital and 8 survived, 2 of them have survived for more than 1 year. Symptoms were improved in 5 patients and unchanged in 3 patients.Conclusions PML is common in patients with HIV/AIDS. It is reliable to diagnose the disease through clinical manifestations, routine detection of cerebrospinal fluid, imaging and cerebrospinal fluid NGS sequencing. Strong and effective antiretroviral treatment may improve the prognosis of patients.

scholarly journals Atypical cutaneous and musculoskeletal manifestation of SARS-CoV-2: ‘COVID-19 toes’ and spasticity in a 48-year-old woman

2021 ◽  
Vol 14 (3) ◽  
pp. e241410
Author(s):  
Avery Kopacz ◽  
Cameron Ludwig ◽  
Michelle Tarbox
Keyword(s):  
Nervous System ◽  
Adult Patient ◽  
Early Identification ◽  
Lower Limbs ◽  
Rare Occurrence ◽  
Cutaneous Manifestations ◽  
Crucial Component ◽  
History Of ◽  
Screening Questions ◽  
Insight Into

Establishing accurate symptomatology associated with novel diseases such as COVID-19 is a crucial component of early identification and screening. This case report identifies an adult patient with a history of clotting dysfunction presenting with rare cutaneous manifestations of COVID-19, known as ‘COVID-19 toes’', previously described predominantly in children. Additionally, this patient presented with possible COVID-associated muscle spasticity of the lower limbs, as well as a prolonged and atypical timeline of COVID-19 infection. The rare occurrence of ‘COVID-19 toes’' in this adult patient suggests that her medical history could have predisposed her to this symptom. This supports the coagulopathic hypothesis of this manifestation of COVID-19 and provides possible screening questions for patients with a similar history who might be exposed to the virus. Additionally, nervous system complaints associated with this disease are rare and understudied, so this novel symptom may also provide insight into this aspect of SARS-CoV-2.

AN EPIDEMIC OF ASEPTIC MENINGITIS SYNDROME DUE TO ECHO VIRUS TYPE 6

PEDIATRICS ◽  
1962 ◽  
Vol 29 (3) ◽  
pp. 418-431
Author(s):  
David T. Karzon ◽  
Norman S. Hayner ◽  
Warren Winkelstein ◽  
Almen L. Barron
Keyword(s):  
Cerebrospinal Fluid ◽  
Aseptic Meningitis ◽  
Virus Type ◽  
Alimentary Tract ◽  
Febrile Illness ◽  
Acute Onset ◽  
Etiologic Agent ◽  
Abdominal Muscles ◽  
Older Children ◽  
Echo Virus

The clinical features of 130 cases of aseptic meningitis syndrome associated with ECHO virus type 6 infection were studied. Characteristically, the onset was acute with the development of fever, headache, muscle pains, and vomiting. A biphasic course was present in 8% of the cases. The physical findings included mild to moderate stiffness or spasm of the neck, back, and posterior thigh muscles. Disturbance in sensorium, cranial nerve involvement, and bulbar signs were conspicuously absent. Absence of deep tendon and superficial reflexes occurred in 16% of the cases. Evidence of mild muscle weakness occurred in 39% of cases, more commonly in the axial rather than peripheral muscles. Most of these patients had bilateral weakness of the anterior neck muscles, but included in the group were five with bilateral weakness of the back or abdominal muscles and six with some involvement of the extremities. Neuromuscular changes were mild and frequently questionable. Where follow-up was available, the changes were usually found to be transient. The effect of age upon the clinical picture was analyzed. Only 3 of 130 patients were less than 4 years of age. Young children had a more acute onset and were admitted to the hospital more promptly than older children and adults. The incidence of pleurodynia was 38% in adults and only 5% in patients less than 20 years of age. The cerebrospinal fluid revealed pleocytosis, with lymphocyte counts ranging from a few cells to 930/mm3. The protein values exceeded 40 mg/100 ml in 48% of the cases, the highest value being 102 mg/100 ml. An undifferentiated febrile illness in household associates of patients with aseptic meningitis, characterized by headache, vomiting and muscle pain, was associated with a high recovery rate of ECHO 6 virus. This is presumably the forme fruste of the fully developed aseptic meningitis syndrome. ECHO 6 virus was recovered from four patients in whom there was evidence of neurologic involvement beyond that seen in the aseptic meningitis syndrome. ECHO 6 virus was the probable etiologic agent in two of these cases. A 15-year-old girl with mild encephalitis marked by disorientation, hallucinations, and weakness of the legs yielded ECHO 6 from her alimentary tract. ECHO 6 was recovered from the cerebrospinal fluid and alimentary tract of a 15-year-old boy with features of the Guillain-Barré syndrome.

The Study on the Clinical Phenotype and Function of HPRT1 Gene

2021 ◽  
Author(s):  
Miao Guo ◽  
Yucai Chen ◽  
Longlong Lin ◽  
Yilin Wang ◽  
Anqi Wang ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Clinical Manifestations ◽  
Protein Translation ◽  
Dimensional Structure ◽  
Normal Individuals ◽  
Second Generation Sequencing ◽  
Self Harm ◽  
And Function ◽  
Neurogenetic Disease ◽  
Generation Sequencing

Abstract Background: Lesch-Nyhan disease (LND) is a rare x-linked purine metabolic neurogenetic disease caused by enzyme hypoxanthine-guanine phosphoriribosyltransferase(HGprt) deficiency, also known as self-destructive appearance syndrome. A series of manifestations are caused by abnormal purine metabolism. The typical clinical manifestations are hyperuricemia, growth retardation, mental retardation, short stature, dance-like athetosis, aggressive behavior, and compulsive self-harm.. Results: we identified a point mutation c.151C > T (p. Arg51*) in a pedigree. We analyzed the clinical characteristics of children in a family, and obtained the blood of their parents and siblings for second-generation sequencing. At the same time, we also analyzed and compared the expression of HPRT1 gene and predicted the three-dimensional structure of the protein. And we analyzed the clinical manifestations caused by the defect of the HPRT1 genethe mutation led to the termination of transcription at the 51st arginine, resulting in the production of truncated protein, and the relative expression of HPRT1 gene in patients was significantly lower than other family members and 10 normal individuals. Conclusion: this mutation leads to the early termination of protein translation and the formation of a truncated HPRT protein, which affects the function of the protein and generates corresponding clinical manifestations.

scholarly journals Development and Optimization of Metagenomic Next-Generation Sequencing Methods for Cerebrospinal Fluid Diagnostics

2018 ◽  
Vol 56 (9) ◽  
Author(s):  
Patricia J. Simner ◽  
Heather B. Miller ◽  
Florian P. Breitwieser ◽  
Gabriel Pinilla Monsalve ◽  
Carlos A. Pardo ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Next Generation Sequencing ◽  
Sample Pretreatment ◽  
Standard Of Care ◽  
Nucleic Acid Amplification ◽  
Next Generation ◽  
Bead Beating ◽  
Dna And Rna ◽  
Positive Threshold ◽  
Generation Sequencing

ABSTRACT The purpose of this study was to develop and optimize different processing, extraction, amplification, and sequencing methods for metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) specimens. We applied mNGS to 10 CSF samples with known standard-of-care testing (SoC) results (8 positive and 2 negative). Each sample was subjected to nine different methods by varying the sample processing protocols (supernatant, pellet, neat CSF), sample pretreatment (with or without bead beating), and the requirement of nucleic acid amplification steps using DNA sequencing (DNASeq) (with or without whole-genome amplification [WGA]) and RNA sequencing (RNASeq) methods. Negative extraction controls (NECs) were used for each method variation (4/CSF sample). Host depletion (HD) was performed on a subset of samples. We correctly determined the pathogen in 7 of 8 positive samples by mNGS compared to SoC. The two negative samples were correctly interpreted as negative. The processing protocol applied to neat CSF specimens was found to be the most successful technique for all pathogen types. While bead beating introduced bias, we found it increased the detection yield of certain organism groups. WGA prior to DNASeq was beneficial for defining pathogens at the positive threshold, and a combined DNA and RNA approach yielded results with a higher confidence when detected by both methods. HD was required for detection of a low-level-positive enterovirus sample. We demonstrate that NECs are required for interpretation of these complex results and that it is important to understand the common contaminants introduced during mNGS. Optimizing mNGS requires the use of a combination of techniques to achieve the most sensitive, agnostic approach that nonetheless may be less sensitive than SoC tools.

scholarly journals A Rare Case of Intraparenchymal Cerebrospinal Fluid Cyst Associated With Ventriculoperitoneal Shunt in an Adult Patient

Cureus ◽  
2021 ◽  
Author(s):  
Pinak Shah ◽  
Kartika Shetty ◽  
Maycky Tang ◽  
Elnaz Saberi ◽  
Nazanin Sheikhan
Keyword(s):  
Cerebrospinal Fluid ◽  
Adult Patient ◽  
Ventriculoperitoneal Shunt ◽  
Rare Case
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