Abstract
BackgroundPrimary amoebic meningoencephalitis (PAM), caused by Naegleria fowleri, is a rare protozoan infectious disease in China. A fatality rate of over 95% had been reported due to extremely rapid disease progression in the USA and other countries. Rapid and precise identification of the causative agent is very important to clinicians for guiding their choices for administering countermeasures in the clinic. In this report, we applied the next-generation sequencing (NGS) method to rapidly show that N. fowleri was the causative agent of a fatal case involving a 42-year-old man with severe PAM disease, the first reported in mainland China.Case presentationA 42-year old male in a deep coma was admitted to Shenzhen Third People’s Hospital, a special medical care unit with expertise in infectious diseases. Increased intracranial pressure was detected. The cerebrospinal fluid (CSF) sample was found to be red and cloudy with increased leukocyte and protein levels. While bacterial cultures with CSF were negative, N. fowleri was determined to be the causative agent with NGS. Amphotericin B (AmB), a drug with anti-amoeba activity, was used immediately, but the treatment came too late and the patient died 2 days after the NGS confirmation.ConclusionIn this paper, we reported a case of PAM disease for the first time in mainland China. NGS was used for rapid diagnosis and provided guidance for prescribing medications. However, the patient died due to a late admission amid advanced PAM disease. Early detection of N. fowleri is necessary in order to select effective drug treatments and control the disease progression. Despite the negative survival outcome, NGS was shown to be a promising method of rapid and precise identification of N. fowleri.
Highlights
Primary amoebic meningoencephalitis (PAM), caused by Naegleria fowleri, is a rare protozoan infectious disease in China
In this paper, we reported a case of PAM disease for the first time in mainland China
Primary amoebic meningoencephalitis (PAM) is an acute and rapidly fatal disease of the central nervous system, caused by infection with Naegleria fowleri, a thermophilic free-living amoeba found in warm freshwater such as lakes, ponds, rivers and hot springs [1]
Summary
The NGS method was shown to be of use to rapidly identify the causative pathogen in the clinic, especially for PAM. Other microbe reads including that of bacterium, fungi and virus were listed in Additional file 1 (Excel table). All authors have read and approved the final manuscript. Author details 1Shenzhen Key Laboratory of Pathogen and Immunity, State Key Discipline of Infectious Disease, Shenzhen Third People’s Hospital, 29 Bulan Rd, Shenzhen 518112, China.
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