Chinese Journal of Contemporary Neurology and Neurosurgery ›› 2020, Vol. 20 ›› Issue (7): 638-642. doi: 10.3969/j.issn.1672-6731.2020.07.014

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Next-generation sequencing technology in the diagnosis of five patients with human herpesvirus encephalitis/meningitis

JIN Ke1, WANG Xiao-juan1, GUAN Hong-zhi2, QIN Ling-zhi1, JIA Ya-zhen1, ZHOU Ke-ke1, MA Hai-chang1, WANG Yue1, WANG Fang1, XING Li3, LI Wei1   

  1. 1 Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou 450003, He'nan, China;
    2 Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China;
    3 Tianjin-Beijing Genomics Institute, Tianjin 300450, China
  • Received:2020-07-09 Online:2020-07-25 Published:2020-07-24
  • Supported by:

    This study was supported by the Key Project of Medical Science and Technology in He'nan Province (No. 2018020427).

第二代测序技术在五例人类疱疹病毒性脑炎和(或)脑膜炎诊断中的应用

金珂1, 王晓娟1, 关鸿志2, 秦灵芝1, 贾亚珍1, 周珂珂1, 马海畅1, 王月1, 王芳1, 邢丽3, 李玮1   

  1. 1 450003 郑州大学人民医院神经内科;
    2 100730 中国医学科学院 北京协和医学院 北京协和医院神经内科;
    3 300450 天津华大基因科技有限公司医学检验所
  • 通讯作者: 李玮,Email:liwein@zzu.edu.cn
  • 基金资助:

    2018年度河南省医学科技攻关计划联合共建项目(项目编号:2018020427)

Abstract:

Objective To evaluate the value of next-generation sequencing (NGS) of cerebrospinal fluid (CSF) in the diagnosis of human herpesvirus encephalitis/meningitis. Methods The clinical features, laboratory and imaging findings of 5 patients with highly suspected human herpesvirus encephalitis/meningitis from January to September 2018 were retrospectively analyzed, and then the etiological sources were comprehensively analyzed combined with the results of NGS. Results All of the 5 patients had an acute onset, fever, headache and neck ankylosis. The CSF tests revealed a slight increased level of white blood cell count (74-260)×106/L. Among them, a total of 4-5406 nucleic acid sequences of human herpesvirus, including human herpesvirus type Ⅰ (n=1), human herpesvirus type Ⅲ (n=3) and human herpesvirus type Ⅳ (n=1) were detected by NGS, with the coverage varing from 0.08% to 81.01%. Conclusions NGS of CSF can assist the diagnosis of human herpesvirus encephalitis/meningitis, as well as viruses accurate classification, which is worth popularizing and applying in clinic.

Key words: Encephalitis, viral, Meningitis, viral, Herpesviridae infections, Cerebrospinal fluid, Genetic testing

摘要:

目的 评估脑脊液第二代测序技术在人类疱疹病毒性脑炎和(或)脑膜炎诊断中的应用价值。方法 对2018年1-9月5例高度疑似人类疱疹病毒性脑炎和(或)脑膜炎患者的临床特征、实验室和影像学表现进行回顾分析,并结合脑脊液第二代测序结果综合分析病原学来源。结果 临床表现为急性发病,以发热、头痛、颈项强直等为主要症状与体征,脑脊液白细胞计数(74~260)×106/L;第二代测序共分离与鉴定病毒1属3种,检出人类疱疹病毒Ⅰ型1例、Ⅲ型3例和Ⅳ型1例;人类疱疹病毒核酸序列数为4~5406条,将鉴定的读数映射到病毒基因组的覆盖度为0.08%~81.01%。结论 脑脊液第二代测序技术可辅助人类疱疹病毒性脑炎和(或)脑膜炎的诊断,并可对病毒进行准确分型,值得在临床推广应用。

关键词: 脑炎, 病毒性, 脑膜炎, 病毒性, 疱疹病毒科感染, 脑脊髓液, 基因检测