https://orcid.org/0000-0003-4036-7440
-
Views
-
Cite
Cite
B Yao, S Li, P Zhao, Rare Central nervous system infection by Chryseobacterium indologenes diagnosed using metagenomic next-generation sequencing, QJM: An International Journal of Medicine, Volume 117, Issue 11, November 2024, Pages 815–817, https://doi.org/10.1093/qjmed/hcae150
Close - Share Icon Share
Extract
Case representation
A 65-year-old Chinese female patient presented after experiencing a sudden headache lasting one day, altered consciousness and vomiting. She had no history of systemic disease. Upon admission, her pupils were non-reactive to light. Cranial computed tomography revealed subarachnoid and intraventricular hemorrhage (Figure 1A). Computed tomography angiography showed a ruptured cerebral aneurysm. Immediate interventional embolization of the cerebral aneurysm and lumbar cistern drainage were performed (Figure 1B). Her symptoms improved gradually. Intravenous ceftriaxone was initiated. However, 4 days later, she developed fever and headache. Cerebrospinal fluid (CSF) leucocyte counts were 910 × 106/L (reference, 0–8 × 106/L), and her C-reactive protein level was 80.5 mg/L (reference, 0.5–10 mg/L). These clinical characteristics and laboratory findings led to a diagnosis of central nervous system infection. Two days later, her condition worsened, with CSF leucocyte counts rising to 1188 × 106/L. CSF cultures were negative.
...
On day 3 after fever, CSF mNGS confirmed the presence of Chryseobacterium indologenes (Genome coverage position, 2864000 and 2864400 bp) (Figure 1C). Consequently, due to cephalosporin resistance, the antibiotic regimen was adjusted to oral trimethoprim-sulfamethoxazole (0.8 g/day) and intravenous levofloxacin (0.75 g/day) for 1 week. Her symptoms resolved completely, with CSF leucocyte counts decreasing to 12 × 106/L and CSF microbial cultures remaining negative. Post-treatment CSF mNGS results were normal.
