Xu CQ, Chen XL, Zhang DS, Wang JW, Yuan H, Chen WF, Xia H, Zhang ZY, Peng FH. Diagnosis of cytomegalovirus encephalitis using metagenomic next-generation sequencing of blood and cerebrospinal fluid: A case report. World J Clin Cases 2022; 10(14): 4601-4607 [PMID: 35663067 DOI: 10.12998/wjcc.v10.i14.4601]
Corresponding Author of This Article
Fu-Hua Peng, PhD, Doctor, Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China. pengfh@mail.sysu.edu.cn
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 16, 2022; 10(14): 4601-4607 Published online May 16, 2022. doi: 10.12998/wjcc.v10.i14.4601
Diagnosis of cytomegalovirus encephalitis using metagenomic next-generation sequencing of blood and cerebrospinal fluid: A case report
Chang-Qing Xu, Xia-Ling Chen, Dong-Sheng Zhang, Jia-Wei Wang, Hong Yuan, Wei-Fan Chen, Han Xia, Zhong-Yin Zhang, Fu-Hua Peng
Chang-Qing Xu, Xia-Ling Chen, Dong-Sheng Zhang, Jia-Wei Wang, Hong Yuan, Wei-Fan Chen, Zhong-Yin Zhang, Department of Neurology, Dongguan Kanghua Hospital, Dongguan 523080, Guangdong Province, China
Han Xia, Department of Scientific Affairs, Hugobiotech Co., Ltd., Beijing 100176, China
Fu-Hua Peng, Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
Author contributions: Peng FH, Zhang ZY, and Xu CQ directly participated in planning and execution; Xu CQ, Chen XL, Zhang DS, Wang JW, Yuan H, and Chen WF collected and organized the data; Lou Z and Xia H contributed in metagenomic next-generation sequencing experiment and result analysis; Peng FH, Xu CQ, Chen XL, and Zhang DS analyzed the data; Xu CQ, Chen XL, Zhang DS, and Wang JW drafted and revised the manuscript; all the authors read and approved the final manuscript.
Informed consent statement: This study was approved by the ethical review committee of First Affiliated Hospital of Anhui Medical University. Written informed consent was obtained from the patient.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fu-Hua Peng, PhD, Doctor, Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China. pengfh@mail.sysu.edu.cn
Received: October 15, 2021 Peer-review started: October 15, 2021 First decision: December 17, 2021 Revised: December 23, 2021 Accepted: March 25, 2022 Article in press: March 25, 2022 Published online: May 16, 2022 Processing time: 210 Days and 1.4 Hours
Abstract
BACKGROUND
Cytomegalovirus (CMV) infections in the population are mostly subclinical, inapparent, or latent. However, it is rare in brain tissue. Most reported CMV encephalitis cases were patients with immunodeficiency. The diagnosis and detection rate of CMV encephalitis in patients with normal immune function needs to be further improved.
CASE SUMMARY
An 86-year-old male was admitted due to a sudden onset of unconsciousness for 3 h. The patient developed status epilepticus and was relieved after antiepileptic treatment. Encephalitis was considered due to the high signals of diffusion-weighted imaging sequences in the right central region by magnetic resonance imaging. Metagenomic next-generation sequencing (mNGS) of blood and cerebrospinal fluid revealed CMV, with unique reads number being 614 and 1, respectively. Simultaneous quantitative PCR results showed CMV positive in blood samples and negative in cerebrospinal fluid samples. The patient was finally diagnosed as CMV encephalitis with status epilepticus. After the antiviral, hormonal, and γ-globulin pulse therapy, the patient’s condition improved, and he was finally discharged.
CONCLUSION
mNGS could be a reliable approach for the diagnosis of CMV encephalitis, with high efficiency, sensitivity, and specificity.
Core Tip: Cytomegalovirus infection in brain tissue is rare, and the diagnosis is limited. Here we report a case of cytomegalovirus encephalitis that was diagnosed by metagenomic next-generation sequencing using blood and cerebrospinal fluid samples. This indicated that metagenomic next-generation sequencing could be a reliable approach for the diagnosis of cytomegalovirus encephalitis with high efficiency, sensitivity, and specificity.
