脑脊液mNGS协助诊断新型布尼亚病毒脑炎1例

Metagenomic next-generation sequencing of cerebrospinal fluid assisted in the diagnosis of novel Bunyavirus encephalitis:a case report

发热伴血小板减少综合征布尼亚病毒侵犯神经系统可引起发热伴血小板减少综合征脑炎,其临床表现无特异性,病原学检测困难,临床医生对此认识不足,容易误诊、漏诊。本文报告1例59岁男性患者,以发热、血小板减少、意识障碍及多器官功能衰竭为主要临床表现,临床考虑病毒性脑炎但无病原学证据,遂行脑脊液宏基因组学二代测序检测出新型布尼亚病毒,给予利巴韦林治疗后病情好转。

Severe fever with thrombocytopenia syndrome Bunyavirus can invade the nervous system and cause severe fever with thrombocytopenia syndrome encephalitis.Its clinical manifestations are non-specific,and pathogen detection is difficult.Clinicians have insufficient awareness,leading to potential misdiagnosis and underdiagnosis.This article reports a 59-year-old male patient with clinical major manifestations including fever,thrombocytopenia,consciousness disorders,and multiple organ failure.Viral encephalitis was considered clinically,but there was no pathogenic evidence.Metagenomic next-generation sequencing(mNGS)of cerebrospinal fluid detected a novel Bunyavirus.After treatment with ribavirin,the patient’s condition improved.