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Identification of the cause of a brain abscess by direct 16S ribosomal DNA sequencing
J M Logan1, G V Orange, A F Maggs
1Department of Medical Microbiology, University of Dundee Medical School, Ninewells Hospital, UK.
Abstract:
We report the case of a young man who apparently suffered successive episodes of meningitis and cerebral abscess over a 1-month period, both of which were diagnosed by two different molecular approaches; PCR for Neisseria meningitidis IS1106 from CSF and 16S rRNA gene sequencing on a specimen of brain pus. In each case, cultures were negative due to prior antibiotic therapy.
Insights
Molecular diagnostics successfully identified Neisseria meningitidis in meningitis and brain abscess cases. This was achieved despite negative cultures from prior antibiotic treatment, highlighting advanced diagnostic capabilities.
Area of Science:
- Neurology
- Infectious Diseases
- Molecular Diagnostics
Background:
- Meningitis and cerebral abscess are serious infections requiring accurate and timely diagnosis.
- Conventional culture methods can be hindered by prior antibiotic administration.
- Molecular diagnostic techniques offer alternative approaches for pathogen identification.
Observation:
- A young male patient presented with successive episodes of meningitis and cerebral abscess within a month.
- Cultures from cerebrospinal fluid (CSF) and brain pus specimens were negative.
Findings:
- Polymerase Chain Reaction (PCR) targeting the IS1106 gene confirmed Neisseria meningitidis in CSF.
- 16S rRNA gene sequencing identified the causative agent in the brain abscess specimen.
- Both molecular methods provided diagnoses despite negative culture results due to antibiotic therapy.
Implications:
- Molecular diagnostics are crucial for identifying pathogens when cultures fail, especially after antibiotic treatment.
- This case underscores the utility of PCR and gene sequencing in diagnosing complex neurological infections.
- Advanced molecular techniques enhance the ability to manage and treat severe infectious conditions effectively.