An unusual case report of brain abscess caused by prevotella loescheii identified using the metagenomic next-generation sequencing.

OBJECTIVES: Brain abscess (BA) is a rare and life-threatening disease which remains to be a challenge for physicians despite recent advances in both the diagnosis and treatment strategies. Appropriate management of brain abscesses requires a combined surgical and medical approach to prevent associated life-threatening complications. In clinical practice, new diagnostic techniques, such as metagenomic next-generation sequencing (mNGS) and quantitative electroencephalogram (qEEG), can help physicians identify the causative pathogens of brain abscesses in order to provide early pathogen-targeted therapy.

CLINICAL PRESENTATION: Here, we report a case of a 27-year-old Chinese woman with a Prevotella loescheii brain abscess into ventricular system. The diagnosis of the causative pathogen was identified by mNGS of abscess drainage fluid, leading to precise and targeted antimicrobial therapy and successful management of the abscess. We, therefor, avoided devastating consequences of the intraventricular rupture of the brain abscess.

CONCLUSION: Appropriate management of BA requires a combination of both surgical and medical approaches. The increasing availability of molecular diagnostic techniques, such as the mNGS that is used to elucidate the microbial composition of the abscesses for definitive diagnosis, is likely to drive the future development of optimal treatment strategies for BA.