Validation of α-herpes viruses in cerebrospinal fluid from patients with intracranial infection by next-generation sequencing
10.3760/cma.j.issn.1671-8925.2019.04.011
- VernacularTitle:脑脊液病原菌二代测序在α疱疹病毒颅内感染诊断中的应用
- Author:
Jie LU
1
;
Hongzhi GUAN
;
Duohao WANG
;
Donglin ZHU
;
Junxiong YIN
;
Haitao REN
;
JingPing SHI
Author Information
1. 南京医科大学附属脑科医院神经内科
- Keywords:
Next-generation sequencing;
Cerebrospinal fluid;
α-herpes viruse;
Encephalitis;
Meningitis
- From:
Chinese Journal of Neuromedicine
2019;18(4):387-391
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the diagnostic value of next-generation sequencing (NGS) in α-herpes virus meningitis or encephalitis.Methods A multicenter clinical registration study of encephalitis based on Department of Neurology of Peking Union Hospital from July 2015 to July 2018 was performed;15 patients with meningitis or encephalitis caused by α-herpes virus in Nanjing Brain Hospital and Peking Union Hospital were identified by NGS of cerebrospinal fluid (CSF).The verification results of further CSF virus PCR or antibody detection,the results of lumbar puncture,electroencephalogram and MRI detection,and the nucleic acid sequence analysis results of background bacteria in these 15 patients were observed.Results In these 15 patients with CSF α-herpes virus infection,8 were with herpes simplex virus (HSV)-1 infection,two with HSV-2 infection and 5 with varicella zoster virus (VZV) infection;four were further tested by CSF virus PCR,and 8 were further tested by antibody IgM,and the results were all positive.The protein content in CSF biochemical examination was slightly increased to (0.91±0.50) g/L.EEG abnormalities were observed in 9 patients;MR imaging abnormalities were observed in 6 patients with HSV-1 encephalitis,presenting as abnormal high signals in MR imaging T2 phase in the medial temporal lobe,hippocampus,cingulate gyrus and insula,which could be mainly involved in one side or both sides simultaneously.Eleven patients had fever,and the highest temperature was (38.6±0.61) ℃;13 patients had headache,8 had abnormal mentalbehavior and 7 had decreased consciousness.All patients showed different levels of suspicious background microorganisms;the most common background bacteria were propionibacterium acacne (13.7％),staphylococcus epidermidis (9.59％),pseudomonas (8.22％) and acid-eating bacteria (6.85％).Conclusion CSF NGS could be used in diagnosis of intracranial α-herpes virus infection,which can be a supplement diagnostic method currently.
