摘要
目的探讨基于外周血宏基因二代测序(mNGS)技术诊断儿童广州管圆线虫脑膜炎的可行性。方法回顾分析确诊为广州管圆线虫脑膜炎患儿的临床资料和mNGS检测结果。结果男女各1例,分别为11和20月龄。均有未熟淡水水产品接触史,病情危重,经历较长时间重症监护室治疗。外周血和脑脊液的嗜酸性粒细胞比值均明显升高。颅脑磁共振成像示脑膜强化。外周血和脑脊液mNGS均检测到广州管圆线虫,序列数分别为90和4059以及529和718。2例患儿经阿苯达唑联合小剂量激素治疗后均完全康复。结论外周血mNGS检查有助于无创、快速且精准地诊断儿童广州管圆线虫脑膜炎。
Objective To explore the feasibility of blood metagenomic next-generation sequencing-based diagnosis of Angiostrongylus cantonensis(AC)meningitis in children.Methods The blood and cerebrospinal fluid(CSF)of the children diagnosed as intracranial infection in the Department of Neurology,Shenzhen Children's Hospital from July 2017 to December 2019 were simultaneously sent to Shenzhen Huada Gene Company for mNGS examination.And comprehensive analysis was performed on the clinical data and mNGS results of children with AC meningitis.Results Two cases of AC meningitis were confirmed among the 65 children with blood and CSF sent for mNGS examination.Case one was an 11-month-old female infant,and Case two was a 20-month-old male infant.Both of the two cases were misdiagnosed at the beginning of the disease,and had a history of exposure to uncooked freshwater aquatic products,and were in critical condition and underwent long-term PICU hospitalization.The eosinophil ratio in the blood and CSF of two cases was significantly increased,and the brain MRI enhanced scan of two cases showed meningeal enhancement.In case one,AC was detected in both blood and CSF mNGS,and the sequence number was 90 and 4059,respectively.In case one,AC was also detected in both blood and CSF mNGS,and the sequence number was 529 and 718,respectively.The two cases were cured after treatment with albendazole and low dose glucocorticoid.Conclusion Blood mNGS examination is expected to be a non-invasive,rapid and accurate new method for the diagnosis of AC meningitis in children.
作者
罗智强
廖建湘
LUO Zhiqiang;LIAO Jianxiang(Department of Neurology,Shenzhen Children's Hospital,Shenzhen 518038,Guangdong,China)
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2021年第8期579-582,共4页
Journal of Clinical Pediatrics
基金
深圳市医疗卫生三名工程项目(No.SZSM 201812005)
广东省高水平临床重点专科(深圳市配套建设经费)资助(No.SZGSP012)
深圳市医学重点学科建设经费资助(No.SZXK033)。
关键词
广州管圆线虫脑膜炎
外周血宏基因二代测序
诊断
儿童
Angiostrongylus cantonensis meningitis
blood metagenomic next-generation sequencing
diagnosis
child
