Published online Jul 16, 2023. doi: 10.12998/wjcc.v11.i20.4912
Peer-review started: March 12, 2023
First decision: May 8, 2023
Revised: May 21, 2023
Accepted: June 26, 2023
Article in press: June 26, 2023
Published online: July 16, 2023
Processing time: 122 Days and 2.7 Hours
The clinical symptoms and imaging manifestations of neurocysticercosis (NCC) are very different, and the difficulty and delay of clinical diagnoses may lead to an increase in mortality and disability. Rapid and accurate pathogen identification is important for the treatment of these patients. Metagenomic next-generation sequencing (mNGS) is a powerful tool to identify pathogens, especially in infections that are difficult to identify by conventional methods.
A 43-year-old male patient was admitted due to a recurrent headache for a few months. Imaging examinations showed hydrocephalus and cystic lesions, which were considered to be a central nervous system infection, but no etiology was found by routine examination. mNGS of the cerebrospinal fluid revealed high Taenia solium reads, and the positive results of a cysticercosis antibody test confirmed the infection. Combined with the patient’s clinical manifestations, the etiological evidence, and the imaging manifestation, the patient was finally diagnosed with NCC and he was prescribed dexamethasone, albendazole, neurotrophic drugs, and intracranial pressure reduction therapy. The headaches disappeared after anti-parasite treatment, and no associated symptoms recurred prior to the three- and six-month follow-up.
As an accurate and sensitivity detection method, mNGS can be a reliable approach for the diagnosis of NCC.
Core Tip: Neurocysticercosis (NCC) infection is rare, and the diagnostic methods are limited. Here we report a case of Taenia solium infection that was diagnosed by metagenomic next-generation sequencing (mNGS) using cerebrospinal fluid samples. Finally, after anti-parasite treatment, the headaches disappeared and the patient recovered well, and various indicators gradually returned to normal during the follow-up period. This indicates that mNGS can be a reliable approach for the diagnosis of NCC, due to its accuracy and sensitivity.