Acute West Nile Virus Meningoencephalitis Diagnosed Via Metagenomic Deep Sequencing of Cerebrospinal Fluid in a Renal Transplant Patient.
Am J Transplant
; 17(3): 803-808, 2017 03.
Article
en En
| MEDLINE
| ID: mdl-27647685
ABSTRACT
Solid organ transplant patients are vulnerable to suffering neurologic complications from a wide array of viral infections and can be sentinels in the population who are first to get serious complications from emerging infections like the recent waves of arboviruses, including West Nile virus, Chikungunya virus, Zika virus, and Dengue virus. The diverse and rapidly changing landscape of possible causes of viral encephalitis poses great challenges for traditional candidate-based infectious disease diagnostics that already fail to identify a causative pathogen in approximately 50% of encephalitis cases. We present the case of a 14-year-old girl on immunosuppression for a renal transplant who presented with acute meningoencephalitis. Traditional diagnostics failed to identify an etiology. RNA extracted from her cerebrospinal fluid was subjected to unbiased metagenomic deep sequencing, enhanced with the use of a Cas9-based technique for host depletion. This analysis identified West Nile virus (WNV). Convalescent serum serologies subsequently confirmed WNV seroconversion. These results support a clear clinical role for metagenomic deep sequencing in the setting of suspected viral encephalitis, especially in the context of the high-risk transplant patient population.
Palabras clave
basic (laboratory) research/science; clinical research/practice; diagnostic techniques and imaging; genetics; genomics; infection and infectious agents; infectious disease; kidney (allograft) function/dysfunction; kidney transplantation/nephrology; viral: Epstein-Barr Virus (EBV); viral: West Nile, infection and infectious agents
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Fiebre del Nilo Occidental
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Virus del Nilo Occidental
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Trasplante de Riñón
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Secuenciación de Nucleótidos de Alto Rendimiento
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Rechazo de Injerto
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Fallo Renal Crónico
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Meningoencefalitis
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Female
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Humans
Idioma:
En
Revista:
Am J Transplant
Asunto de la revista:
TRANSPLANTE
Año:
2017
Tipo del documento:
Article
País de afiliación:
Canadá