Diagnosis of Streptococcus suis Meningoencephalitis with metagenomic next-generation sequencing of the cerebrospinal flu
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CASE REPORT
Open Access
Diagnosis of Streptococcus suis Meningoencephalitis with metagenomic next-generation sequencing of the cerebrospinal fluid: a case report with literature review Xiaobo Zhang1*, Zhaoping Wu2 and Kai Wang1
Abstract Background: Streptococcus suis meningoencephalitis is a zoonotic disease that mostly infects slaughterhouse workers. Rapid diagnosis of Streptococcus suis meningoencephalitis is critical for effective clinical management of this condition. However, the current diagnostic techniques are not effective for early diagnosis of this condition. To the best of our knowledge, the use of cerebrospinal fluid metagenomic next generation sequencing in the diagnosis of Streptococcus suis meningoencephalitis has been rarely reported. Case presentation: Here, we report a case of Streptococcus suis meningoencephalitis in a 51-year-old female patient. The patient had a history of long-term contact with pork and had a three-centimeter-long wound on her left leg prior to disease onset. Conventional tests, including blood culture, gram staining and cerebrospinal fluid culture, did not reveal bacterial infection. However, Streptococcus suis was detected in cerebrospinal fluid using metagenomic next generation sequencing. Conclusions: Metagenomic next generation sequencing is a promising approach for early diagnosis of central nervous system infections. This case report indicates that cases of clinical meningeal encephalitis of unknown cause can be diagnosed through this method. Keywords: Streptococcus suis, Meningoencephalitis, Cerebrospinal fluid, Metagenomic next-generation sequencing
Background Streptococcus suis (S. suis) is a zoonotic pathogen that may cause serious illness in pigs and people who have occupational contact with pigs and pork, such as farmers, slaughterhouse workers and butchers [1]. In humans, S. suis infection may cause serious infections and complications including meningitis and septicemia. * Correspondence: [email protected] 1 Department of Neurology, The First People’s Hospital Of Changde City, 818 Renmin Road, Changde 415000, Hunan Province, China Full list of author information is available at the end of the article
Meningitis is the most frequent clinical manifestation of S. suis infection, and deafness is the most common sequelae in survivors [2, 3]. About 50–60% of S. suis infections occur even in the absence of obvious wounds after contact with pigs or pork, and may be asymptomatic in the early stages. Moreover, disease progression is rapid, and the pathogen may directly enter circulation causing meningeal encephalitis [2, 4]. However, the clinical incidence of S. suis meningitis is very low (3%) which often leads to misdiagnosis of this condition, especially in the context of pneumococcal meningitis (20%) and Listeria
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