Next-Generation Sequencing of Cerebrospinal Fluid for the Diagnosis of Neurocysticercosis.

Siyuan Fan,Haitao Ren,Lei Liu,Jiawei Wang,Qiang Lu,Liying Cui,Qing Chen,Ruixue Sun,Chenhui Mao,Ying Ge,Xiaodong Qiao,Honglong Wu,Jing Yuan,Yongjun Li,Hongzhi Guan,Weili Zhao,Jiali Zhou,Yan Huang

doi:10.3389/fneur.2018.00471

Abstract

Background: Neurocysticercosis (NCC) is the most common helminthic infection of the central nervous system (CNS). The diagnosis of NCC is sometimes challenging due to its heterogenous clinical manifestations and the variable sensitivity and specificity of neuroimaging and serological tests.Methods: Next-generation sequencing (NGS) of cerebrospinal fluid (CSF) was used to detect pathogens in patients with clinically suspected CNS infections. A series of patients diagnosed with NCC is reviewed here.Results: Using NGS of CSF, four patients were diagnosed with NCC. The reads corresponding to Taenia solium ranged from 478 to 117,362, with genomic coverage of 0.0564–11.15%. Reads corresponding to T. solium were not found in non-template controls and far exceeded those of the background microorganisms in patients with NCC, facilitating the interpretation of the NGS results.Conclusions: This case series demonstrates that NGS of CSF is promising in the diagnosis of NCC in difficult to diagnose cases. Larger studies are needed in the future.

Highlights

Neurocysticercosis (NCC) is an infection of the central nervous system (CNS) and its meningeal coverings caused by the larval stage of the tapeworm Taenia solium [1]
Of the 381 patients with clinically suspected CNS infections, four patients with NCC were identified by NGS of CSF
All four patients were diagnosed with probable neurocysticercosis according to the diagnostic criteria for NCC [5]

Summary

Introduction

Neurocysticercosis (NCC) is an infection of the central nervous system (CNS) and its meningeal coverings caused by the larval stage of the tapeworm Taenia solium [1]. It is endemic in resourcelimited areas where pigs are raised. The clinical manifestations and neuroimaging findings of NCC vary greatly due to factors such as the number, stage, size, and location of parasites in the nervous system [4]. Neurocysticercosis (NCC) is the most common helminthic infection of the central nervous system (CNS). The diagnosis of NCC is sometimes challenging due to its heterogenous clinical manifestations and the variable sensitivity and specificity of neuroimaging and serological tests

Methods

Results

Conclusion