Department of Pathology, SUNY Upstate Medical University, Syracuse, New York.
Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Clin Infect Dis. 2015 Nov 15;61(10):1543-8. doi: 10.1093/cid/civ643. Epub 2015 Aug 3.
Human and animal poxvirus infections are being reported with increasing frequency. We describe a challenging case history and treatment of a previously unknown poxvirus rash illness in a renal transplant patient.
A combination of classical microbiology techniques, including viral culture and electron microscopy, were used to provide initial clinical diagnosis. Subsequent standard polymerase chain reaction assays available in 2001 were noncontributory. Next generation sequencing was used to provide definitive diagnosis.
Retrospectively, next generation sequencing methods were used to ultimately provide the definitive diagnosis of a novel poxvirus infection initially identified by electron microscopy. The closest relative of this poxvirus, identified in North America, is a poxvirus collected from a mosquito pool from Central Africa in 1972.
This diagnostic quandary was ultimately solved using next generation DNA sequencing. This article describes the use of classical and next generation diagnostic strategies to identify etiologic agents of emerging infectious diseases and once again demonstrates the susceptibility of immunossupressed patients to novel pathogens. The virus identified is closely related to Yoka virus; these viruses appear to have independently diverged from a common ancestor of all known orthopoxviruses.
人类和动物痘病毒感染的报告频率正在增加。我们描述了一个具有挑战性的病例历史和治疗方法，在一个肾移植患者中出现了一种以前未知的痘病毒疹疾病。
采用经典的微生物学技术，包括病毒培养和电子显微镜，进行初步临床诊断。随后在 2001 年进行的标准聚合酶链反应检测没有提供帮助。下一代测序用于提供明确的诊断。
回顾性地，下一代测序方法最终提供了一个新的痘病毒感染的明确诊断，该病毒最初通过电子显微镜识别。在北美的这种痘病毒最接近的亲缘病毒，是 1972 年从中非的蚊子池中采集的痘病毒。
使用下一代 DNA 测序解决了这一诊断难题。本文描述了使用经典和下一代诊断策略来识别新发传染病的病原体，并再次证明免疫抑制患者容易感染新型病原体。鉴定出的病毒与 Yoka 病毒密切相关；这些病毒似乎是从所有已知正痘病毒的共同祖先中独立分化而来的。
