宏基因组二代测序在儿童布鲁氏菌脑炎诊治中的应用价值探索

Clinical value of mNGS in the diagnosis and treatment of brucella encephalitis in children

目的探索脑脊液宏基因组二代测序(metagenomics next generation sequencing,mNGS)在中枢神经系统布鲁氏菌感染中的诊治价值。方法收集2020年11月至2021年2月山东大学附属儿童医院住院并临床疑诊为中枢神经系统布鲁氏菌感染的2例患者的临床资料分析儿童中枢神经系统布鲁氏菌感染的临床、实验室检查结果的特点,探索mNGS在布鲁氏菌脑炎临床诊治中的应用。结果2例患者均有羊接触史,均为急性起病伴发热,1例头晕,1例颈肩部疼痛伴有呕吐。影像学检查表现为半卵圆中心受累。脑脊液常规白细胞计数升高,以单核细胞为主,蛋白质水平增加,葡萄糖水平降低。脑脊液mNGS检测出布鲁氏菌的核酸序列数为(175~389)条,覆盖度为(0.05~0.11)%。结论脑脊液mNGS能够辅助中枢神经系统布鲁氏菌感染的临床诊断,有利于患者的及时诊疗。

Objective To study the diagnostic value of metagenomics next generation sequencing(mNGS)in the Brucellainfection in the central nervous system.Methods The clinical data of two patients admitted to Children's Hospital affiliated to Shandong Universityfrom November 2020to February 2021were retrospectively analyzed,and these two patients were clinically suspected to be Brucella infection of the central nervous system.Results Both patients had a history of contact with sheep,all of them had acute onset with fever,one had dizziness,and one had neck and shoulder pain with vomiting.Radiographic examination showed semioval center altered in the two cases.The white blood cells(which are mainly monocytes)and protein increased,meanwhile glucose decreased in cerebrospinal fluid.The number of Brucella nucleic acid sequences detected by mNGS in cerebrospinal fluid was(175-389),and the coverage was(0.05-0.11)%.Conclusion mNGS can assist the clinical to diagnosis the Brucellainfection in central nervous system,and is beneficial to timely diagnosis and treatment of patients.