Detection of Listeria monocytogenes in a patient with meningoencephalitis using next-generation sequencing: a case repor
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CASE REPORT
Open Access
Detection of Listeria monocytogenes in a patient with meningoencephalitis using next-generation sequencing: a case report Zi-Wei Lan1, Min-Jia Xiao1, Yuan-lin Guan2, Ya-Jing Zhan1* and Xiang-Qi Tang1*
Abstract Background: Listeria monocytogenes (L. monocytogenes) is a facultative intracellular bacterial pathogen which can invade different mammalian cells and reach to the central nervous system (CNS), leading to meningoencephalitis and brain abscesses. In the diagnosis of L. monocytogenes meningoencephalitis (LMM), the traditional test often reports negative owing to the antibiotic treatment or a low number of bacteria in the cerebrospinal fluid. To date, timely diagnosis and accurate treatment remains a challenge for patients with listeria infections. Case presentation: We present the case of a 66-year-old woman whose clinical manifestations were suspected as tuberculous meningoencephalitis, but the case was finally properly diagnosed as LMM by next-generation sequencing (NGS). The patient was successfully treated using a combined antibacterial therapy, comprising ampicillin and trimethoprim-sulfamethoxazole. Conclusion: To improve the sensitivity of LMM diagnosis, we used NGS for the detection of L. monocytogenes. Hence, the clinical utility of this approach can be very helpful since it provides quickly and trust results. Keywords: Listeria monocytogenes, Meningoencephalitis, Cerebrospinal fluid, Next-generation sequencing
Background Listeria monocytogenes (L. monocytogenes) is a Grampositive bacillus, its genetic machinery allows bacterial life as a facultative intracellular pathogen. L. monocytogenes widely exists in the environment at high salt concentrations and fairly low moisture content [1]. It is well adapted to survive and persist in food processing facilities, entering the final products (such as ready-to-eat) by cross-contamination. Additionally, this organism is also psychrophilic and has a competitive advantage over other Gram-positive and Gram-negative microorganisms in cold environments, such as refrigerators [2]. The consumption of contaminated foods is considered the main cause leading of listeriosis. * Correspondence: [email protected]; [email protected] 1 The Second Xiangya Hospital, Central South University, No.139 Middle Renmin Road, Changsha 410011, Hunan, China Full list of author information is available at the end of the article
Invasive forms of listeriosis can lead to infection of CNS, in these cases even though the adequate antibiotic treatment the overall mortality rates remains nearly 30% [3]. The clinical manifestations of LMM are usually uncharacteristic, thus hindering prompt diagnosis [4]. Due to adequate antibiotic therapy or low number of bacteria, traditional approaches often fail to detect L. monocytogenes in the cerebrospinal fluid (CSF) [5]. Therefore, to enhance the diagnostic accuracy of LMM, an unbiased diagnostic approach is necessary. Next-generation sequencing (NGS) is a comprehensive and equitable pathogen detection tool, with the pot
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