Gao Dai-Quan, Hu Yong-Qiang, Wang Xin, Zhang Yun-Zhou
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Department of Critical Care Medicine, Beijing Fengtai You'anmen Hospital, Beijing 100069, China.
World J Clin Cases. 2022 Feb 16;10(5):1697-1701. doi: 10.12998/wjcc.v10.i5.1697.
Bacterial meningitis (BM) is a common central nervous system inflammatory disease. BM may cause serious complications, and early diagnosis is essential to improve the prognosis of affected patients.
A 37-year-old man was hospitalized with purulent meningitis because of worsening headache for 12 h, accompanied by vomiting, fever, and rhinorrhea. Head computed tomography showed a lesion in the left frontal lobe. Infectious disease screening showed positivity for hepatitis B surface antigen, hepatitis B e antigen, and hepatitis B core antigen. Cerebrospinal fluid (CSF) leak was suspected based on clinical history. () was detected in CSF by metagenomic next-generation sequencing (mNGS) technology, confirming the diagnosis of purulent BM. After treatment, multiplex PCR indicated the presence of hepatitis B virus (HBV) DNA and absence of DNA in CSF samples.
We report a rare case of HBV in the CSF of a patient with purulent BM. Multiplex PCR is more sensitive than mNGS for detecting HBV DNA.
细菌性脑膜炎（BM）是一种常见的中枢神经系统炎症性疾病。BM可能导致严重并发症，早期诊断对于改善受影响患者的预后至关重要。
一名37岁男性因头痛加重12小时伴呕吐、发热和流涕入院，诊断为化脓性脑膜炎。头颅计算机断层扫描显示左额叶有病变。传染病筛查显示乙肝表面抗原、乙肝e抗原和乙肝核心抗原呈阳性。根据临床病史怀疑有脑脊液（CSF）漏。通过宏基因组下一代测序（mNGS）技术在CSF中检测到（），确诊为化脓性BM。治疗后，多重聚合酶链反应表明CSF样本中存在乙肝病毒（HBV）DNA且不存在（此处原文缺失信息）DNA。
我们报告了一例化脓性BM患者CSF中罕见的HBV病例。多重聚合酶链反应在检测HBV DNA方面比mNGS更敏感。
