Xiaofei Fei1, Chaoyang Li1, Yun Zhang1, Hongya Zhang1, Xuewu Liu1, Xinchao Ji1, Yajun Shi1, Na Liu1, Mengli Wu1, Fang Du1, Yining Yang1, Wen Dai1, TingTing Liu1, Ying He1, Ting Bian1, Huimin Zhou1, Xingyue An1, Zheng Cai1, Jian Shi2, Guodong Feng3, Ming Shi4, Gang Zhao5. 1. Department of Neurology, Xijing Hospital, The Fourth Military Medical University, 15 Changle xi Road, Xi'an, 710032, China. 2. Department of Neurology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan, China. 3. Department of Neurology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. Electronic address: feng.guodong@zs-hospital.sh.cn. 4. Department of Neurology, Xijing Hospital, The Fourth Military Medical University, 15 Changle xi Road, Xi'an, 710032, China. Electronic address: biomidas@163.com. 5. Department of Neurology, Xijing Hospital, The Fourth Military Medical University, 15 Changle xi Road, Xi'an, 710032, China. Electronic address: zhaogang@fmmu.edu.cn.
Abstract
OBJECTIVE: Neurocysticercosis (NCC) is the most common parasitic disease of the human central nervous system (CNS). However, a diagnosis of NCC may be hard to make if the specific clinical and routine neuroimaging manifestations are lacking, which hinders physicians from considering further immunodiagnostic tests. PATIENTS AND METHODS: Seven patients presented with fever, headache, nausea, cognitive decline, confusion, or progressive leg weakness. There were no pathogens found in the cerebrospinal fluid (CSF); patients were clinically suspected of meningoencephalitis or cerebrovascular disease. To clearly determine the etiology, next generation sequencing (NGS) of the CSF was used to detect pathogens in these seven patients. RESULTS: Taenia solium DNA sequences were detected in the seven patients, but not in the non-template controls (NTCs) or the other patients with clinically suspected CNS infections. Based on the patients' medical data and the diagnostic criteria for NCC, seven patients were diagnosed with probable NCC. The unique reads aligning to Taenia solium ranged from 6 to 261064, with genomic coverage ranging from 0.0003% to 14.8079%. The number of unique reads and genomic coverage dropped in three of the seven patients after antiparasitic treatment, consistent with the relief of symptoms. CONCLUSION: This study showed that NGS of the CSF might be an auxiliary diagnostic method for NCC patients. Larger studies are required.
OBJECTIVE:Neurocysticercosis (NCC) is the most common parasitic disease of the human central nervous system (CNS). However, a diagnosis of NCC may be hard to make if the specific clinical and routine neuroimaging manifestations are lacking, which hinders physicians from considering further immunodiagnostic tests. PATIENTS AND METHODS: Seven patients presented with fever, headache, nausea, cognitive decline, confusion, or progressive leg weakness. There were no pathogens found in the cerebrospinal fluid (CSF); patients were clinically suspected of meningoencephalitis or cerebrovascular disease. To clearly determine the etiology, next generation sequencing (NGS) of the CSF was used to detect pathogens in these seven patients. RESULTS:Taenia solium DNA sequences were detected in the seven patients, but not in the non-template controls (NTCs) or the other patients with clinically suspected CNS infections. Based on the patients' medical data and the diagnostic criteria for NCC, seven patients were diagnosed with probable NCC. The unique reads aligning to Taenia solium ranged from 6 to 261064, with genomic coverage ranging from 0.0003% to 14.8079%. The number of unique reads and genomic coverage dropped in three of the seven patients after antiparasitic treatment, consistent with the relief of symptoms. CONCLUSION: This study showed that NGS of the CSF might be an auxiliary diagnostic method for NCCpatients. Larger studies are required.