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病例报告:通过宏基因组下一代测序诊断一名患有无菌性脑膜炎的急性Q热患者。

Case Report: Diagnosis of Acute Q Fever With Aseptic Meningitis in a Patient by Using Metagenomic Next-Generation Sequencing.

作者信息

Gu Meifeng, Mo Xiaoqin, Tang Zhenchu, Tang Jianguang, Wang Wei

机构信息

Department of Neurology, the Second Xiangya Hospital, Central South University, Changsha, China.

Hunan Key Laboratory of Tumor Models and Individualized Medicine, the Second Xiangya Hospital, Central South University, Changsha, China.

出版信息

Front Med (Lausanne). 2022 May 18;9:855020. doi: 10.3389/fmed.2022.855020. eCollection 2022.

Abstract

Query fever (Q fever) is a widespread zoonotic disease caused by the bacterium of (). Its neurological complications are rarely reported. But they may lead to severe consequences. It needs a rapid and accurate detective method to diagnose acute Q fever with neurological presentations in non-epidemic areas urgently. Here, we report an acute Q fever case with aseptic meningitis. The male patient, without any contact history in the epidemic area or with animals, was indicated to exhibit fever and headache symptoms. The cultures of blood, stool, urine, and sputum were all negative. But was repeatedly detected in blood by metagenomic next-generation sequencing (mNGS). He received Doxycycline therapy and quickly returned to normal. Therefore, for the diagnosis and identification of Q fever in non-reporting regions, mNGS has comparative advantages. Secondly, aseptic meningitis may be a direct infection of to central nervous system (CNS) or inflammatory reactions to systemic infection, we recommend detecting mNGS both in blood and cerebrospinal fluid (CSF).

摘要

Query热(Q热)是一种由()细菌引起的广泛传播的人畜共患病。其神经系统并发症鲜有报道。但它们可能导致严重后果。在非流行地区,迫切需要一种快速准确的检测方法来诊断伴有神经系统表现的急性Q热。在此,我们报告一例伴有无菌性脑膜炎的急性Q热病例。该男性患者在疫区或与动物无任何接触史,表现出发热和头痛症状。血液、粪便、尿液和痰液培养均为阴性。但通过宏基因组下一代测序(mNGS)在血液中反复检测到()。他接受了强力霉素治疗并很快恢复正常。因此,对于非报告地区Q热的诊断和鉴定,mNGS具有比较优势。其次,无菌性脑膜炎可能是()直接感染中枢神经系统(CNS)或全身性感染的炎症反应,我们建议同时检测血液和脑脊液(CSF)中的mNGS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2307/9157756/2b200beb4044/fmed-09-855020-g0001.jpg

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