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. 2017 Nov 24;6(4):393-398.
doi: 10.1093/jpids/piw066.

Neurobrucellosis: Unexpected Answer From Metagenomic Next-Generation Sequencing

Kanokporn Mongkolrattanothai  1 , Samia N Naccache  2   3   4 , Jeffrey M Bender  1 , Erik Samayoa  3   4 , Elizabeth Pham  3   4 , Guixia Yu  3   4 , Jennifer Dien Bard  2 , Steve Miller  3   4 , Grace Aldrovandi  1   5 , Charles Y Chiu  3   6   4
Affiliations

Neurobrucellosis: Unexpected Answer From Metagenomic Next-Generation Sequencing

Kanokporn Mongkolrattanothai et al. J Pediatric Infect Dis Soc. .

Abstract

A diagnosis of brucellosis can be difficult because routine culture and serological methods exhibit variable sensitivity and specificity. We present the use of a metagenomic next- generation sequencing assay to diagnose a case of neurobrucellosis from cerebrospinal fluid, resulting in the institution of appropriate antibiotic treatment and a favorable clinical outcome.

Keywords: diagnostic microbiology; encephalitis; meningitis; metagenomic next-generation sequencing; neurobrucellosis.

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Figures

Figure 1.
Figure 1.
Contrast-enhanced T1-weighted magnetic resonance imaging of the lumbar spine from the case patient. Smooth and linear leptomeningeal enhancement is observed along the margins of the conus medullaris (arrow) and involves the cauda equina without underlying signal abnormality of the spinal cord or vertebral bodies.
Figure 2.
Figure 2.
Polymerase chain reaction (PCR) confirmation of Brucella in the case patient’s cerebrospinal fluid (CSF). Shown is a globally contrast- enhanced image of the 2% agarose gel from Brucella PCR targeting a 177-base pair region of the IS711 gene. The lanes correspond to (1) patient CSF sample extract, (2) no-template control (NTC), (3) positive control (PC) mixture of 7 organisms, (4) water, and (“DNA ladder”) 1 kb Plus DNA ladder (Invitrogen). The PCR amplicon from the patient’s CSF extract was sequenced and identified as Brucella spp. Abbreviation: DNA, deoxyribonucleic acid.
See this image and copyright information in PMC

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