摘要
<b>Objective:</b> <i>Angiostrongylus cantonensis</i> (<i>A. cantonensis</i>) is an important parasite, which causes neurological infection in children, and is generally difficult to diagnose. We analyzed the significance of metagenomic next-generation sequencing in diagnosing <i>A. cantonensis</i> encephalitis/meningitis in children to provide a reference for clinical diagnosis. <b>Methods:</b> The case collection of <i>A. cantonensis</i> encephalitis/meningitis was from July 2018 to August 2020. The patients’ clinical characteristics and pathogen were described, and diagnostic sensitivity methods for <i>A. cantonensis</i> encephalitis/meningitis were compared and analyzed, including parasite antibody detection and metagenomic next-generation sequencing (mNGS) detection in different samples. <b>Results:</b> Eleven cases were diagnosed with <i>A. cantonensis</i> encephalitis/meningitis, including six males (54.5%) and five females (45.5%), and the age ranged from 1 to 13 years with a median of 21 months (IQR: 15.6, 96). All patients were undiagnosed upon admission, of which ten cases had neurological symptoms or signs, six cases (54.5%) had a history of definite or suspicious exposure to parasites, and eight cases (72.7%) had abnormal changes in cranial MRI. The results of <i>A. cantonensis</i> antibodies in the peripheral blood and cerebrospinal fluid (CSF) were compared with CSF’s metagenomic next-generation sequencing (mNGS). The antibody-positive rate of peripheral blood was 54.5%, CSF antibody-positive rate was 27.2%, and mNGS-positive rate of CSF was 81.8%, and the positive diagnostic rate of the latter was significantly higher than the former two (<i>p</i> = 0.035 < 0.05 and <i>p</i> = 0.030 < 0.05, respectively). <b>Conclusion:</b> Metagenomic next-generation sequencing has a higher positive rate for diagnosing infection and plays an important role in clarifying diagnosis and reducing misdiagnosis.
<b>Objective:</b> <i>Angiostrongylus cantonensis</i> (<i>A. cantonensis</i>) is an important parasite, which causes neurological infection in children, and is generally difficult to diagnose. We analyzed the significance of metagenomic next-generation sequencing in diagnosing <i>A. cantonensis</i> encephalitis/meningitis in children to provide a reference for clinical diagnosis. <b>Methods:</b> The case collection of <i>A. cantonensis</i> encephalitis/meningitis was from July 2018 to August 2020. The patients’ clinical characteristics and pathogen were described, and diagnostic sensitivity methods for <i>A. cantonensis</i> encephalitis/meningitis were compared and analyzed, including parasite antibody detection and metagenomic next-generation sequencing (mNGS) detection in different samples. <b>Results:</b> Eleven cases were diagnosed with <i>A. cantonensis</i> encephalitis/meningitis, including six males (54.5%) and five females (45.5%), and the age ranged from 1 to 13 years with a median of 21 months (IQR: 15.6, 96). All patients were undiagnosed upon admission, of which ten cases had neurological symptoms or signs, six cases (54.5%) had a history of definite or suspicious exposure to parasites, and eight cases (72.7%) had abnormal changes in cranial MRI. The results of <i>A. cantonensis</i> antibodies in the peripheral blood and cerebrospinal fluid (CSF) were compared with CSF’s metagenomic next-generation sequencing (mNGS). The antibody-positive rate of peripheral blood was 54.5%, CSF antibody-positive rate was 27.2%, and mNGS-positive rate of CSF was 81.8%, and the positive diagnostic rate of the latter was significantly higher than the former two (<i>p</i> = 0.035 < 0.05 and <i>p</i> = 0.030 < 0.05, respectively). <b>Conclusion:</b> Metagenomic next-generation sequencing has a higher positive rate for diagnosing infection and plays an important role in clarifying diagnosis and reducing misdiagnosis.
作者
Xiaowei Fan
Qiang Wang
Peiqing Li
Bin Ai
Yongling Song
Qiuyan Peng
Hongli Wang
Xiaowei Fan;Qiang Wang;Peiqing Li;Bin Ai;Yongling Song;Qiuyan Peng;Hongli Wang(Pediatric Emergency Department, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China;Pediatric Radiology Department, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China;Pediatric Gastroenterology Department, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China)
