Xu Wen-Bin, Fu Juan-Juan, Yuan Xiao-Ju, Xian Qing-Jie, Zhang Li-Jun, Song Ping-Ping, You Zhi-Qing, Wang Cheng-Tan, Zhao Qi-Gang, Pang Feng
Department of Clinical Laboratory, Liaocheng People's Hospital, Liaocheng 252000, Shandong Province, China.
Department of Gastroenterology, Liaocheng People's Hospital, Liaocheng 252000, Shandong Province, China.
World J Clin Cases. 2023 Jul 16;11(20):4912-4919. doi: 10.12998/wjcc.v11.i20.4912.
The clinical symptoms and imaging manifestations of neurocysticercosis (NCC) are very different, and the difficulty and delay of clinical diagnoses may lead to an increase in mortality and disability. Rapid and accurate pathogen identification is important for the treatment of these patients. Metagenomic next-generation sequencing (mNGS) is a powerful tool to identify pathogens, especially in infections that are difficult to identify by conventional methods.
A 43-year-old male patient was admitted due to a recurrent headache for a few months. Imaging examinations showed hydrocephalus and cystic lesions, which were considered to be a central nervous system infection, but no etiology was found by routine examination. mNGS of the cerebrospinal fluid revealed high reads, and the positive results of a cysticercosis antibody test confirmed the infection. Combined with the patient's clinical manifestations, the etiological evidence, and the imaging manifestation, the patient was finally diagnosed with NCC and he was prescribed dexamethasone, albendazole, neurotrophic drugs, and intracranial pressure reduction therapy. The headaches disappeared after anti-parasite treatment, and no associated symptoms recurred prior to the three- and six-month follow-up.
As an accurate and sensitivity detection method, mNGS can be a reliable approach for the diagnosis of NCC.
神经囊尾蚴病（NCC）的临床症状和影像学表现差异很大，临床诊断的困难和延误可能导致死亡率和残疾率上升。快速准确地鉴定病原体对这些患者的治疗很重要。宏基因组下一代测序（mNGS）是鉴定病原体的有力工具，尤其是在常规方法难以鉴定的感染中。
一名43岁男性患者因反复头痛数月入院。影像学检查显示脑积水和囊性病变，被认为是中枢神经系统感染，但常规检查未发现病因。脑脊液的mNGS显示读数较高，囊尾蚴病抗体检测阳性结果证实了感染。结合患者的临床表现、病因证据和影像学表现，最终诊断为NCC，并给予地塞米松、阿苯达唑、神经营养药物和降低颅内压治疗。抗寄生虫治疗后头痛消失，在三个月和六个月随访前未出现相关症状复发。
作为一种准确且灵敏的检测方法，mNGS可以成为诊断NCC的可靠方法。
