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Precise diagnosis of Neisseria macacae infective endocarditis assisted by nanopore sequencing

Jing-Wen Ai1, Hong Liu2, Hui-Xia Li1,3

  • 1Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.

Emerging Microbes & Infections
|August 8, 2020
PubMed

Insights

Infective endocarditis from Neisseria macacae is rare in humans. This case highlights successful surgical and antibiotic treatment for aortic valve infection caused by this unusual pathogen.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Infective endocarditis (IE) is a serious infection of the heart valves.
  • Bacterial causes of IE are diverse, but Neisseria species, particularly Neisseria macacae, are uncommon pathogens.
  • Native aortic valve endocarditis presents significant clinical challenges.

Observation:

  • A 61-year-old male presented with symptoms suggestive of infective endocarditis.
  • The patient had a native aortic valve infection.
  • Neisseria macacae was identified as the causative agent through blood cultures and metagenomic sequencing.

Findings:

  • Nanopore-based metagenomic sequencing confirmed Neisseria macacae in cardiac vegetations.
  • Blood cultures yielded Neisseria macacae, establishing the diagnosis.
  • The patient received a combination of surgical intervention and antibiotic therapy.

Implications:

  • This case expands the spectrum of known pathogens causing infective endocarditis.
  • Metagenomic sequencing offers a powerful tool for diagnosing rare infectious agents in endocarditis.
  • Prompt diagnosis and multimodal treatment, including surgery and antibiotics, are crucial for favorable outcomes in N. macacae IE.
Keywords:
Neisseria macacaeNeisseria spInfective endocarditisnanopore sequencingvalve replacement

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