Author(s)

Xiaowei Fan^1*, Qiang Wang^1*, Peiqing Li¹, Bin Ai², Yongling Song¹, Qiuyan Peng¹, Hongli Wang^3#

¹Pediatric Emergency Department, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China.
²Pediatric Radiology Department, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China.
³Pediatric Gastroenterology Department, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China.

Objective: Angiostrongylus cantonensis (A. cantonensis) 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 A. cantonensis encephalitis/meningitis in children to provide a reference for clinical diagnosis. Methods: The case collection of A. cantonensis encephalitis/meningitis was from July 2018 to August 2020. The patients’ clinical characteristics and pathogen were described, and diagnostic sensitivity methods for A. cantonensis encephalitis/meningitis were compared and analyzed, including parasite antibody detection and metagenomic next-generation sequencing (mNGS) detection in different samples. Results: Eleven cases were diagnosed with A. cantonensis 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 A. cantonensis 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 (p = 0.035 < 0.05 and p = 0.030 < 0.05, respectively). Conclusion: Metagenomic next-generation sequencing has a higher positive rate for diagnosing infection and plays an important role in clarifying diagnosis and reducing misdiagnosis.

Angiostrongylus cantonensis Encephalitis, Meningitis, Diagnosis, Metagenomic Next-Generation Sequencing

Fan, X. , Wang, Q. , Li, P. , Ai, B. , Song, Y. , Peng, Q. and Wang, H. (2021) The Diagnostic Value of Metagenomic Next-Generation Sequencing in Angiostrongylus cantonensis Encephalitis/Meningitis. Journal of Behavioral and Brain Science, 11, 216-226. doi: 10.4236/jbbs.2021.119017.