The Diagnostic Value of Metagenomic Next-Generation Sequencing in Angiostrongylus cantonensis Encephalitis/Meningitis ()
Affiliation(s)
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.
ABSTRACT
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.
Share and Cite:
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.