Xu WB, Fu JJ, Yuan XJ, Xian QJ, Zhang LJ, Song PP, You ZQ, Wang CT, Zhao QG, Pang F. Metagenomic next-generation sequencing in the diagnosis of neurocysticercosis: A case report. World J Clin Cases 2023; 11(20): 4912-4919 [PMID: 37584000 DOI: 10.12998/wjcc.v11.i20.4912]
Corresponding Author of This Article
Feng Pang, MD, PhD, Professor, Department of Clinical Laboratory, Liaocheng People’s Hospital, No. 67 Dongchang Road, Liaocheng 252000, Shandong Province, China. pangfeng01@163.com
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/
Wen-Bin Xu, Juan-Juan Fu, Qing-Jie Xian, Ping-Ping Song, Zhi-Qing You, Cheng-Tan Wang, Qi-Gang Zhao, Feng Pang, Department of Clinical Laboratory, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
Xiao-Ju Yuan, Department of Gastroenterology, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
Li-Jun Zhang, Department of Neurology, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
Author contributions: Xu WB, Fu JJ and Yuan XJ contributed equally to this work. Xu WB, Fu JJ, and Yuan XJ carried out the studies, performed the statistical analysis, and drafted the manuscript; Xu WB, Fu JJ, Xian QJ, and Yuan XJ revised the manuscript; Zhang LJ collected the clinical data and analyzed the data; Song PP, You ZQ, and Wang CT contributed in metagenomic next-generation sequencing experiment and result analysis; Pang F and Zhao QG contributed conception and design of the study; and all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Check list (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: Feng Pang, MD, PhD, Professor, Department of Clinical Laboratory, Liaocheng People’s Hospital, No. 67 Dongchang Road, Liaocheng 252000, Shandong Province, China. pangfeng01@163.com
Received: March 12, 2023 Peer-review started: March 12, 2023 First decision: May 8, 2023 Revised: May 21, 2023 Accepted: June 26, 2023 Article in press: June 26, 2023 Published online: July 16, 2023 Processing time: 122 Days and 2.7 Hours
Abstract
BACKGROUND
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.
CASE SUMMARY
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 Taenia solium 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.
CONCLUSION
As an accurate and sensitivity detection method, mNGS can be a reliable approach for the diagnosis of NCC.
Core Tip: Neurocysticercosis (NCC) infection is rare, and the diagnostic methods are limited. Here we report a case of Taenia solium infection that was diagnosed by metagenomic next-generation sequencing (mNGS) using cerebrospinal fluid samples. Finally, after anti-parasite treatment, the headaches disappeared and the patient recovered well, and various indicators gradually returned to normal during the follow-up period. This indicates that mNGS can be a reliable approach for the diagnosis of NCC, due to its accuracy and sensitivity.
