Clinical characteristics of varicella-zoster virus encephalitis/meningitis based on metagenomic next-generation sequencing
10.3760/cma.j.cn115354-20240908-00549
- VernacularTitle:基于宏基因组高通量测序技术的水痘带状疱疹病毒脑炎/脑膜炎的临床特点分析
- Author:
Lining CHONG
1
;
Cuizhi HAN
;
Song LIU
;
Jingzhe HAN
Author Information
1. 哈励逊国际和平医院神经内三科，衡水 053000
- Keywords:
Varicella-zoster virus;
Encephalitis/meningitis;
Metagenomic next-generation sequencing;
Clinical manifestation
- From:
Chinese Journal of Neuromedicine
2024;23(10):1006-1011
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relations of clinical manifestations with sequence numbers detected in the cerebrospinal fluid of varicella-zoster virus (VZV) encephalitis/meningitis patients based on metagenomic next-generation sequencing (mNGS).Methods:Fifty-four VZV encephalitis/meningitis patients admitted to Department of Neurology, Harrison International Peace Hospital from January 2016 to October 2022 were selected. Sequence numbers of VZV in the cerebrospinal fluid of these patients were detected by mNGS; these patients were divided into low-detected sequence number group (≤1 000) and high-detected sequence number group (>1 000) accordingly. Differences in clinical manifestations, auxiliary examination results, treatments and prognoses were compared between the two groups.Results:Twenty-six patients were into low-detected sequence number group and 28 patients were into high-detected sequence number group. Compared with the low-detected sequence number group, the high-detected sequence number group had significantly older age (48.0 [35.5, 65.3] years vs. 63.0 [54.0, 71.8] years), higher proportion of patients using immunosuppressants (0.0% vs. 14.3%), lower proportion of those with meningeal irritation signs (46.2% vs. 17.9%), higher proportions of those with abnormal mental behaviors (15.4% vs. 42.9%), epilepsy (3.8% vs. 28.6%), and consciousness disorders (11.5% vs. 42.9%), greater cerebrospinal fluid pressure (150.0 [127.5, 177.5] mm H 2O vs. 185.0 [152.5, 210.0] mm H 2O), higher electroencephalogram positive rate (11.8% vs. 47.7%), and higher poor prognosis rate at discharge (26.9% vs. 66.7%, P<0.05). Conclusions:The clinical phenotype of the low-detected sequence number group tends to meningitis, while that of the high-detected sequence number group tends to encephalitis. Patients with high-detected sequence numbers have high cerebrospinal fluid pressure and abnormal electroencephalogram, enjoying poor prognosis.
