Diagnosis of Streptococcus suis Meningoencephalitis with metagenomic next-generation sequencing of the cerebrospinal fluid: a case report with literature review

Abstract

Background Streptococcus suis meningoencephalitis is a zoonotic disease that mostly infects slaughterhouse workers. Rapid diagnosis of Streptococcus suis meningoencephalitis is critical for effective clinical management of this condition. However, the current diagnostic techniques are not effective for early diagnosis of this condition. To the best of our knowledge, the use of cerebrospinal fluid metagenomic next generation sequencing in the diagnosis of Streptococcus suis meningoencephalitis has been rarely reported. Case presentation Here, we report a case of Streptococcus suis meningoencephalitis in a 51-year-old female patient. The patient had a history of long-term contact with pork and had a three-centimeter-long wound on her left leg prior to disease onset. Conventional tests, including blood culture, gram staining and cerebrospinal fluid culture, did not reveal bacterial infection. However, Streptococcus suis was detected in cerebrospinal fluid using metagenomic next generation sequencing. Conclusions Metagenomic next generation sequencing is a promising approach for early diagnosis of central nervous system infections. This case report indicates that cases of clinical meningeal encephalitis of unknown cause can be diagnosed through this method.

Polymicrobial Anaerobic Meningitis Detected by Next-Generation Sequencing: Case Report and Review of the Literature

“…mNGS is a novel and promising approach in diagnostic microbiology having the ability to detect many potential microorganisms using a single assay ( 7 , 25 ). Previous studies show that mNGS of CSF obtained from patients with central nervous system infections improved the diagnostic rate and provided actionable information ( 26 , 27 ). In this case, the mNGS detected the pathogens in time and provided a direction for us to identify the source of infection.…”

Spinal canal infection caused by Streptococcus suis in human: a case report

“…So Traditional diagnostic methods are routine, sophisticate, and sometimes insensitive to adequately diagnose the infectious agents [ 19 ]. To better identify the causative agents, several molecular biological techniques such as PCR, real-time PCR or WGS have been applied for diagnosis [ 19 – 21 ]. A study designed to verify the usefulness of multiplex PCR in identifying S. Suis infection demonstrated that this technique can detect S. suis directly from positive hemocultures and CSF, with high sensitivity, specificity compared to culture and serotyping methods.…”

“…A study published in 2019 to verify the real-life usefulness of mNGS in intracranial infection indicates that clinical metagenomic NGS of CSF represents a potential step forward in the diagnosis of meningoencephalitis [ 22 ]. In S. suis infection, there are also several case reports making use of mNGS to identify Streptococcus suis in cerebrospinal fluid and blood samples [ 21 , 23 ] It is worth noting that in these cases, conventional microorganism detection methods are usually negative. But currently it remains difficult to roll out this technology in countries with limited resources.…”

Developing Diagnostic and Therapeutic Approaches to Bacterial Infections for a New Era: Implications of Globalization

“…In terms of diagnosis, it is especially useful when disease etiology is unclear or the list of potential pathogens is broad. Some examples of the identification of viruses [ 18 ] and bacteria [ 19 ] by this method have been reported. Platforms from Illumina, Thermo Fisher, and Pacific Biosciences require proper logistics and high investment as well as trained personnel.…”