宏基因组学是脑脓肿未来的常规诊断工具吗?关于一个案例

William Lars, Claudie Lamoureux, Jérémy Picard, Christophe Rodriguez, Clémence Beauruelle, Luc Quaesaet, Geneviève Héry-Arnaud, Séverine Ansart, Anne Coste
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引用次数: 0

摘要

散弹枪宏基因组学(SMg)在脑脓肿诊断中的作用尚不清楚。我们描述一个病例的脑脓肿诊断为SMg和提供文献回顾。一名70岁的妇女被诊断患有多发性脑脓肿。标准培养技术及16S rRNA基因测序结果均为阴性。SMg最终揭示了来自血管链球菌和核梭杆菌的序列,导致抗菌素治疗的适应和皮质类固醇的启动。病人终于康复了。文献回顾了另外15例被诊断为SMg的脑脓肿。在大多数情况下,SMg结果导致患者管理的改变。然后讨论了关于SMg的性能、优点、未来发展和局限性的现有文献。SMg在日常生活中的地位应通过前瞻性研究进行评估和界定。
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Is Metagenomics the Future Routine Diagnosis Tool for Brain Abscesses? About a Case
Shotgun metagenomics (SMg) usefulness for brain abscess diagnosis is not known. We describe a case of brain abscess diagnosed with SMg and provide a review of the literature. A 70-year-old woman was diagnosed with multiple brain abscesses. Standard culture techniques and 16S rRNA gene sequencing of abscess samples remained negative. SMg finally revealed the presence of sequences from Streptococcus anginosus and Fusobacterium nucleatum, leading to antimicrobial treatment adaptation and corticosteroids initiation. The patient finally recovered. A literature review retrieved fifteen other cases of brain abscesses diagnosed with SMg. SMg results led to changes in patient management in most cases. The existing literature about the performances of SMg, its advantages, future evolutions, and limitations is then discussed. SMg place in routine should be evaluated and defined through prospective studies.
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