The application of shotgun metagenomics to the diagnosis of granulomatous amoebic encephalitis due to Balamuthia mandrillaris: a case report

被引：16

作者：

Hirakata, Shota ^{[1
]}

Sakiyama, Yusuke ^{[1
]}

Yoshimura, Akiko ^{[1
]}

Ikeda, Mei ^{[1
]}

Takahata, Katsunori ^{[1
]}

Tashiro, Yuichi ^{[1
]}

Yoshimura, Michiyoshi ^{[1
]}

Arata, Hitoshi ^{[1
]}

Yonezawa, Hajime ^{[2
]}

Kirishima, Mari ^{[3
]}

Higashi, Michiyo ^{[3
]}

Hatanaka, Miho ^{[4
]}

Kanekura, Takuro ^{[4
]}

Yagita, Kenji ^{[5
]}

Matsuura, Eiji ^{[1
]}

Takashima, Hiroshi ^{[1
]}

机构：

[1] Kagoshima Univ, Grad Sch Med & Dent Sci, Dept Neurol & Geriatr, 8-35-1 Sakuragaoka, Kagoshima, Kagoshima 8908520, Japan

[2] Kagoshima Univ, Dept Neurosurg, 8-35-1 Sakuragaoka, Kagoshima, Kagoshima 8908520, Japan

[3] Kagoshima Univ, Dept Pathol, 8-35-1 Sakuragaoka, Kagoshima, Kagoshima 8908520, Japan

[4] Kagoshima Univ, Dept Dermatol, 8-35-1 Sakuragaoka, Kagoshima, Kagoshima 8908520, Japan

[5] Natl Inst Infect Dis, Dept Parasitol, Shinjuku Ku, 1-23-1 Toyama, Tokyo 1628640, Japan

来源：

BMC NEUROLOGY | 2021年 / 21卷 / 01期

关键词：

Granulomatous amoebic encephalitis; Balamuthia mandrillaris infection; Necrotizing encephalitis; Next-generation sequencer; Shotgun metagenomics; RIBOSOMAL-RNA GENE; MENINGOENCEPHALITIS; HUMANS;

D O I：

10.1186/s12883-021-02418-y

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background Granulomatous amoebic encephalitis (GAE) is an infrequent and fatal infectious disease worldwide. Antemortem diagnosis in this condition is very difficult because clinical manifestations and neuroimaging are nonspecific. Case presentation A 60-year-old Japanese woman was admitted with a chief complaint of left homonymous hemianopsia. Brain-MRI showed extensive necrotizing lesions enhanced by gadolinium, in the right frontal lobe, right occipital lobe, and left parietal lobe. Epithelioid granulomas of unknown etiology were found in the biopsied brain specimens. Shotgun metagenomic sequencing using a next-generation sequencer detected DNA fragments of Balamuthia mandrillaris in the tissue specimens. The diagnosis of granulomatous amoebic encephalitis was confirmed using an amoeba-specific polymerase chain reaction and immunostaining on the biopsied tissues. Conclusions Shotgun metagenomics is useful for the diagnosis of central nervous system infections such as GAE wherein the pathogens are difficult to identify.

引用

页数：6

共 17 条

[1] Identification of Balamuthia mandrillaris by PCR assay using the mitochondrial 16S rRNA gene as a target [J].