PDF(Pubmed)
Abstract：
UNASSIGNED: Rickettsia felis is a kind of zoonotic pathogen. Rickettsia felis infections of the central nervous system are rare with only a few cases reported worldwide. The early diagnosis of R. felis is difficult due to its nonspecific clinical features and laboratory tests. Here, we report two meningitis cases caused by R. felis using metagenomic next-generation sequencing (mNGS).
UNASSIGNED: The clinical data of patients with meningitis who were diagnosed to have R. felis through cerebrospinal fluid culture, nuclear magnetic imaging, mNGS detection from January 2019 to December 2019 in The First Clinical Hospital of Shanxi Medical University, were retrospectively analyzed, and their clinical characteristics and disease regression findings were summarized.
UNASSIGNED: The first case was a female patient aged 23 years who was admitted to our hospital presenting with symptoms of headache, fever, and weakness in both lower limbs. Upon examination of spinal imaging, myelitis was diagnosed. However, routine examination and culture of cerebrospinal fluid did not identify the pathogen responsible. Subsequently, metagenomic second-generation sequencing (mNGS) revealed that the infection was caused by R. felis. The patient responded well to standard treatment and showed signs of recovery. The second case was a male patient aged 29 years who was admitted to our hospital with a headache and fever that had persisted for 4 days within a month. Routine examination and culture of the cerebrospinal fluid did not reveal any identifiable pathogens. However, metagenomic second-generation sequencing (mNGS) determined that the patient had a Rickettsial infection likely transmitted by a cat. The patient showed significant improvement after 14 days of doxycycline treatment. Tests for herpes simplex virus, cytomegalovirus, Epstein-Barr virus and tubercle bacillus nucleic acid in the CSF and blood were negative.Therefore mNGS of the cerebrospinal fluid was used, which identified the pathogen as R. felis. One case was diagnosed as subacute meningitis with immune-associated myelitis and the other as subacute meningitis.
UNASSIGNED: mNGS of cerebrospinal fluid can be used as a fast and effective method to identify intracranial R. felis infections.
UNASSIGNED: The clinical data of patients with meningitis who were diagnosed to have R. felis through cerebrospinal fluid culture, nuclear magnetic imaging, mNGS detection from January 2019 to December 2019 in The First Clinical Hospital of Shanxi Medical University, were retrospectively analyzed, and their clinical characteristics and disease regression findings were summarized.
UNASSIGNED: The first case was a female patient aged 23 years who was admitted to our hospital presenting with symptoms of headache, fever, and weakness in both lower limbs. Upon examination of spinal imaging, myelitis was diagnosed. However, routine examination and culture of cerebrospinal fluid did not identify the pathogen responsible. Subsequently, metagenomic second-generation sequencing (mNGS) revealed that the infection was caused by R. felis. The patient responded well to standard treatment and showed signs of recovery. The second case was a male patient aged 29 years who was admitted to our hospital with a headache and fever that had persisted for 4 days within a month. Routine examination and culture of the cerebrospinal fluid did not reveal any identifiable pathogens. However, metagenomic second-generation sequencing (mNGS) determined that the patient had a Rickettsial infection likely transmitted by a cat. The patient showed significant improvement after 14 days of doxycycline treatment. Tests for herpes simplex virus, cytomegalovirus, Epstein-Barr virus and tubercle bacillus nucleic acid in the CSF and blood were negative.Therefore mNGS of the cerebrospinal fluid was used, which identified the pathogen as R. felis. One case was diagnosed as subacute meningitis with immune-associated myelitis and the other as subacute meningitis.
UNASSIGNED: mNGS of cerebrospinal fluid can be used as a fast and effective method to identify intracranial R. felis infections.
摘要：
■费氏立克次体是一种人畜共患病原体。中枢神经系统的立克次体感染很少见，全世界仅报道了少数病例。由于R.felis的非特异性临床特征和实验室检查，其早期诊断很困难。这里,我们使用宏基因组下一代测序（mNGS）报告了两例由R.felis引起的脑膜炎病例。
■通过脑脊液培养被诊断患有R.felis的脑膜炎患者的临床资料，核磁成像,2019年1月至2019年12月在山西医科大学第一临床医院进行mNGS检测，进行了回顾性分析，并对其临床特征和疾病消退结果进行了总结。
首例是一名23岁的女性患者，入院时出现头痛症状，发烧,双下肢无力.在检查脊柱影像学时，诊断为脊髓炎。然而,常规检查和脑脊液培养未鉴定出病原体。随后，宏基因组第二代测序（mNGS）显示感染是由R.felis引起的。患者对标准治疗反应良好，并显示出康复迹象。第二例是一名29岁的男性患者，因头痛和发烧而入院，一个月内持续了4天。常规检查和脑脊液培养未发现任何可识别的病原体。然而,宏基因组第二代测序（mNGS）确定患者的立克次体感染可能是由猫传播的。多西环素治疗14天后，患者显着改善。单纯疱疹病毒检查,巨细胞病毒,脑脊液和血液中的EB病毒和结核杆菌核酸均为阴性。因此，使用了脑脊液的mNGS，确定病原体为R.felis。1例被诊断为亚急性脑膜炎合并免疫相关脊髓炎，另一例被诊断为亚急性脑膜炎。
■脑脊液的mNGS可作为一种快速有效的方法来识别颅内R.felis感染。
■通过脑脊液培养被诊断患有R.felis的脑膜炎患者的临床资料，核磁成像,2019年1月至2019年12月在山西医科大学第一临床医院进行mNGS检测，进行了回顾性分析，并对其临床特征和疾病消退结果进行了总结。
首例是一名23岁的女性患者，入院时出现头痛症状，发烧,双下肢无力.在检查脊柱影像学时，诊断为脊髓炎。然而,常规检查和脑脊液培养未鉴定出病原体。随后，宏基因组第二代测序（mNGS）显示感染是由R.felis引起的。患者对标准治疗反应良好，并显示出康复迹象。第二例是一名29岁的男性患者，因头痛和发烧而入院，一个月内持续了4天。常规检查和脑脊液培养未发现任何可识别的病原体。然而,宏基因组第二代测序（mNGS）确定患者的立克次体感染可能是由猫传播的。多西环素治疗14天后，患者显着改善。单纯疱疹病毒检查,巨细胞病毒,脑脊液和血液中的EB病毒和结核杆菌核酸均为阴性。因此，使用了脑脊液的mNGS，确定病原体为R.felis。1例被诊断为亚急性脑膜炎合并免疫相关脊髓炎，另一例被诊断为亚急性脑膜炎。
■脑脊液的mNGS可作为一种快速有效的方法来识别颅内R.felis感染。
