Frontiers in medicine · 2026
The value of mNGS in the diagnosis of central nervous system infections in immunodeficient hosts with decompensated cirrhosis complicated by Listeria encephalitis: Case Report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Cao Linman, Zhao Yi, Wang Rongrong, Liu Yijing, Luo Linzheng, Yan Han, Li Na
Аннотация
INTRODUCTION: The incidence of central nervous system (CNS) infections caused by Listeria monocytogenes is rising, yet it remains rarely reported and frequently misdiagnosed in patients with decompensated cirrhosis. This report evaluates the diagnostic utility of metagenomic next-generation sequencing (mNGS) in this specific population.
CASE PRESENTATION: A 62-year-old male with a 7-year history of cirrhosis presented with fever, headache, and loss of consciousness. At admission, the patient was in a decompensated state with a Child-Pugh score of 9 (Grade B) and a Model for End-Stage Liver Disease (MELD) score of 12, characterized by hypoalbuminemia and mild ascites.
DIAGNOSIS AND INTERVENTION: To avoid delayed treatment, broad-spectrum antibiotics were used before the results of blood and cerebrospinal fluid cultures were available. Preliminary cerebrospinal fluid (CSF) analysis showed an atypical inflammatory response in the context of cirrhosis-associated immune dysfunction. Although conventional CSF cultures remained negative, mNGS detected Listeria monocytogenes sequences within 16 h. Early mNGS-guided targeted therapy, followed by multidisciplinary management under real-world drug availability constraints, was associated with significant clinical improvement and successful discharge.
CONCLUSION: Cirrhosis-associated immune dysfunction (CAID) and hypersplenism can mask typical CSF diagnostic markers. mNGS provides a rapid, unbiased diagnostic paradigm that is crucial for shortening diagnostic duration and guiding precision therapy in immunocompromised hosts.
CASE PRESENTATION: A 62-year-old male with a 7-year history of cirrhosis presented with fever, headache, and loss of consciousness. At admission, the patient was in a decompensated state with a Child-Pugh score of 9 (Grade B) and a Model for End-Stage Liver Disease (MELD) score of 12, characterized by hypoalbuminemia and mild ascites.
DIAGNOSIS AND INTERVENTION: To avoid delayed treatment, broad-spectrum antibiotics were used before the results of blood and cerebrospinal fluid cultures were available. Preliminary cerebrospinal fluid (CSF) analysis showed an atypical inflammatory response in the context of cirrhosis-associated immune dysfunction. Although conventional CSF cultures remained negative, mNGS detected Listeria monocytogenes sequences within 16 h. Early mNGS-guided targeted therapy, followed by multidisciplinary management under real-world drug availability constraints, was associated with significant clinical improvement and successful discharge.
CONCLUSION: Cirrhosis-associated immune dysfunction (CAID) and hypersplenism can mask typical CSF diagnostic markers. mNGS provides a rapid, unbiased diagnostic paradigm that is crucial for shortening diagnostic duration and guiding precision therapy in immunocompromised hosts.