Published online May 16, 2022. doi: 10.12998/wjcc.v10.i14.4601
Peer-review started: October 15, 2021
First decision: December 17, 2021
Revised: December 23, 2021
Accepted: March 25, 2022
Article in press: March 25, 2022
Published online: May 16, 2022
Processing time: 210 Days and 1.4 Hours
Cytomegalovirus (CMV) infections in the population are mostly subclinical, inapparent, or latent. However, it is rare in brain tissue. Most reported CMV encephalitis cases were patients with immunodeficiency. The diagnosis and detection rate of CMV encephalitis in patients with normal immune function needs to be further improved.
An 86-year-old male was admitted due to a sudden onset of unconsciousness for 3 h. The patient developed status epilepticus and was relieved after antiepileptic treatment. Encephalitis was considered due to the high signals of diffusion-weighted imaging sequences in the right central region by magnetic resonance imaging. Metagenomic next-generation sequencing (mNGS) of blood and cerebrospinal fluid revealed CMV, with unique reads number being 614 and 1, respectively. Simultaneous quantitative PCR results showed CMV positive in blood samples and negative in cerebrospinal fluid samples. The patient was finally diagnosed as CMV encephalitis with status epilepticus. After the antiviral, hormonal, and γ-globulin pulse therapy, the patient’s condition improved, and he was finally discharged.
mNGS could be a reliable approach for the diagnosis of CMV encephalitis, with high efficiency, sensitivity, and specificity.
Core Tip: Cytomegalovirus infection in brain tissue is rare, and the diagnosis is limited. Here we report a case of cytomegalovirus encephalitis that was diagnosed by metagenomic next-generation sequencing using blood and cerebrospinal fluid samples. This indicated that metagenomic next-generation sequencing could be a reliable approach for the diagnosis of cytomegalovirus encephalitis with high efficiency, sensitivity, and specificity.