Acute viral encephalitis associated with human parvovirus B19 infection: unexpectedly diagnosed by metagenomic next-generation sequencing

Cao, Jing; Zhu, Xiaoqun

doi:10.1007/s13365-020-00885-6

Cited by 9 publications

(6 citation statements)

References 9 publications

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“… 39 Additionally, in some cases, mNGS offered a faster turnaround time for results than traditional culture methods 29 and broader agnostic detection capabilities than nucleic acid amplification testing. 23 , 51 Overall, mNGS exhibits good sensitivity and specificity for diagnosing central nervous system infection and diagnostic performance during clinical application by assisting in identifying the pathogen. However, the efficacy remains inconsistent, which warrants subsequent studies to further improve performance during clinical application.…”

Section: Resultsmentioning

confidence: 99%

“…Metagenomic sequencing was used to determine associations between genotype and clinical phenotype, 46 elucidate etiologies, 23 , 41 , 43 , 44 , 46 investigate a pathogen's epidemiology by subsequent whole-genome capture, 50 and characterize clusters of divergent strains. 39 Additionally, in some cases, mNGS offered a faster turnaround time for results than traditional culture methods 29 and broader agnostic detection capabilities than nucleic acid amplification testing.…”

Section: Resultsmentioning

confidence: 99%

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Literature Review of Pathogen Agnostic Molecular Testing of Clinical Specimens From Difficult-to-Diagnose Patients: Implications for Public Health

Downie,

Rao,

David-Ferdon

et al. 2024

Health Security

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To better identify emerging or reemerging pathogens in patients with difficult-to-diagnose infections, it is important to improve access to advanced molecular testing methods. This is particularly relevant for cases where conventional microbiologic testing has been unable to detect the pathogen and the patient's specimens test negative. To assess the availability and utility of such testing for human clinical specimens, a literature review of published biomedical literature was conducted. From a corpus of more than 4,000 articles, a set of 34 reports was reviewed in detail for data on where the testing was being performed, types of clinical specimens tested, pathogen agnostic techniques and methods used, and results in terms of potential pathogens identified. This review assessed the frequency of advanced molecular testing, such as metagenomic next generation sequencing that has been applied to clinical specimens for supporting clinicians in caring for difficult-to-diagnose patients. Specimen types tested were from cerebrospinal fluid, respiratory secretions, and other body tissues and fluids. Publications included case reports and series, and there were several that involved clinical trials, surveillance studies, research programs, or outbreak situations. Testing identified both known human pathogens (sometimes in new sites) and previously unknown human pathogens. During this review, there were no apparent coordinated efforts identified to develop regional or national reports on emerging or reemerging pathogens. Therefore, development of a coordinated sentinel surveillance system that applies advanced molecular methods to clinical specimens which are negative by conventional microbiological diagnostic testing would provide a foundation for systematic characterization of emerging and underdiagnosed pathogens and contribute to national biodefense strategy goals.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Literature Review of Pathogen Agnostic Molecular Testing of Clinical Specimens From Difficult-to-Diagnose Patients: Implications for Public Health

Downie,

Rao,

David-Ferdon

et al. 2024

Health Security

View full text Add to dashboard Cite

show abstract

“…Various studies have proved the clinical value of mNGS for acute infectious patients. Some studies discussed the application of mNGS in acute viral encephalitis (Cao and Zhu, 2020 ), acute respiratory distress syndrome (Zhang et al, 2021 ; Wang et al, 2022 ), acute respiratory distress syndrome (Zhang et al, 2023 ) and other acute infectious diseases, demonstrating that mNGS is a promising tool for the diagnosis of acute disease caused by multiple infectious agents. mNGS represents a valuable supplementary tool to CM in order to rapidly determine etiological factors of various infections and guide treatment decision- making for patients (Xu et al, 2023 ).…”

Section: Discussionmentioning

confidence: 99%

Higher diagnostic value of metagenomic next-generation sequencing in acute infection than chronic infection: a multicenter retrospective study

Yao,

Wang,

et al. 2024

Front. Microbiol.

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BackgroundThe aim of this study is to compare the diagnostic value of metagenomic next-generation sequencing (mNGS) vs. conventional culture methods (CM) in chronic infection and acute infection.MethodsWe retrospectively analyzed the bronchoalveolar lavage fluid (BALF) of 88 patients with acute infection and 105 patients with chronic infection admitted to three hospitals from 2017 to 2022.ResultsThe results showed that the sensitivity and specificity of mNGS were higher than those of CM. The number of patients who changed the antibiotic treatment in the mNGS positive group was larger than that of patients in the mNGS negative group in both the acute infection group (60.5 vs. 28.0%, P = 0.0022) and chronic infection group (46.2 vs. 22.6%, P = 0.01112). High levels of temperature (OR: 2.02, 95% CI: 1.18–3.70, P: 0.015), C-reactive protein (CRP) (OR: 15, 95% CI: 2.74–280.69, P: 0.011), neutrophil count (OR: 3.09, 95% CI: 1.19–8.43, P: 0.023), and low levels of lymphocyte count (OR: 3.43, 95% CI:1.26–10.21, P: 0.020) may lead to positive mNGS results in the acute infection group while no significant factor was identified to predict positive results in the chronic infection group.ConclusionmNGS could provide useful guidance on antibiotic strategies in infectious diseases and may be more valuable for the diagnosis and treatment of acute infection vs. chronic infection.

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“…It has been postulated that infection initiation stimulates cellular responses in the tissues against the virus which could culminate in a myriad of pathologies, such as meningoencephalitis [3], [36]. B19 infection or the expression of viral proteins could modulate the immune response in the infected tissues by dysregulation of cytokines and production of autoantibodies, or by the cytotoxic effect of the B19 viral nonstructural protein (NS1) damaging cerebrovascular endothelium [9], [37][38][39][40][41][42][43] It has also been postulated that when patients are under immunosuppression or during concomitant infection with other pathogens, the B19 viral load increases, which could evoke a more potent inflammatory disease [3], [44]. In this regard the immature immune response of the newborn could have also contributed to the severe clinical outcome observed in the present case.…”

Section: Discussionmentioning

confidence: 99%

Encephalopathy Caused by Human Parvovirus B19 Genotype 1 Associated With Haemophilus influenzae Meningitis in a Newborn

Ferreira¹,

Costa²,

Kallás³

et al. 2023

Preprint

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Parvovirus B19 infection is associated with a wide range of clinical manifestations, from asymp-tomatic to severe neurological disorders. Its major clinical symptoms, fever and rash, are com-mon to multiple viruses, and laboratory tests to detect B19 are frequently not available. Thus, the impact of B19 on public health remains unclear. We report the case of a 38-day old girl ad-mitted to São Paulo Clinical Hospital, Brazil, with an initial diagnosis of bacterial meningitis, seizures, and acute hydrocephalus. Antibiotic therapy was maintained for one week after admis-sion and discontinued after negative laboratory results were obtained. Nine days after symp-toms onset, a cerebral spinal fluid (CSF) sample revealed persistent pleocytosis. The complete B19 complete genome was subsequently identified in her CSF by a metagenomic next-generation sequencing approach. This report highlights the possible involvement of B19 in the occurrence of acute neurological manifestations, and emphasizes that its possible involve-ment might be better revealed by the use of metagenomic technology to detect viral agents in clinical situations of unknown or uncertain etiology.

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Acute viral encephalitis associated with human parvovirus B19 infection: unexpectedly diagnosed by metagenomic next-generation sequencing

Cited by 9 publications

References 9 publications

Literature Review of Pathogen Agnostic Molecular Testing of Clinical Specimens From Difficult-to-Diagnose Patients: Implications for Public Health

Literature Review of Pathogen Agnostic Molecular Testing of Clinical Specimens From Difficult-to-Diagnose Patients: Implications for Public Health

Higher diagnostic value of metagenomic next-generation sequencing in acute infection than chronic infection: a multicenter retrospective study

Encephalopathy Caused by Human Parvovirus B19 Genotype 1 Associated With Haemophilus influenzae Meningitis in a Newborn

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