Dong Yukang, He Yingying, Zhou Xia, Lv Xia, Huang Jia, Li Yaqi, Qian Xin, Hu Fangfang, Zhu Jiaying
Department of Emergency, Guizhou Provincial People's Hospital, Guiyang, People's Republic of China.
Department of Pharmacy, Guizhou Provincial People's Hospital, Guiyang, People's Republic of China.
Infect Drug Resist. 2022 Aug 12;15:4479-4486. doi: 10.2147/IDR.S371771. eCollection 2022.
meningitis is a rare postoperative complication of neurosurgery. Accurate and early diagnosis of remains challenging because of the limitations of traditional detection methods. Metagenomic next-generation sequencing (mNGS) is an advanced technique with high sensitivity and specificity for identifying infectious pathogens; however, its application in diagnosing meningitis has not been widely studied.
We report the case of a 61-year-old man who presented with fever and headache after neurosurgical treatment for a cerebral hemorrhage. Empiric antibiotic therapy was ineffective. Traditional culture of pathogens and serological testing yielded negative results, but was detected in the cerebrospinal fluid by mNGS. After further verification by polymerase chain reaction (PCR), the patient's clinical treatment was adjusted accordingly. With targeted antibiotic intervention, the patient's symptoms were effectively alleviated, and clinical indicators returned to normal levels. Furthermore, the abundance of decreased significantly compared to the initial mNGS reading after targeted treatment, indicating that the infection caused by was effectively controlled.
Using mNGS, we found that may be a candidate causative agent of meningitis. The technique also has the advantage of timeliness and accuracy that traditional cultures cannot achieve. A combination of mNGS with PCR is recommended to identify pathogens in the early stages of infectious diseases to administer targeted clinical medication.
脑膜炎是神经外科手术后一种罕见的并发症。由于传统检测方法的局限性，准确、早期诊断仍然具有挑战性。宏基因组下一代测序（mNGS）是一种对识别感染性病原体具有高灵敏度和特异性的先进技术；然而，其在诊断脑膜炎中的应用尚未得到广泛研究。
我们报告了一例61岁男性病例，该患者在脑出血神经外科治疗后出现发热和头痛。经验性抗生素治疗无效。病原体的传统培养和血清学检测结果均为阴性，但通过mNGS在脑脊液中检测到了[病原体名称未给出]。经聚合酶链反应（PCR）进一步验证后，相应调整了患者的临床治疗。通过针对性的抗生素干预，患者症状得到有效缓解，临床指标恢复到正常水平。此外，与靶向治疗后的初始mNGS读数相比，[病原体名称未给出]的丰度显著降低，表明由[病原体名称未给出]引起的感染得到了有效控制。
通过mNGS，我们发现[病原体名称未给出]可能是脑膜炎的候选病原体。该技术还具有传统培养无法实现的及时性和准确性优势。建议将mNGS与PCR结合使用，以在传染病早期识别病原体，从而进行针对性的临床用药。
