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Case Report: Metagenomics Next-Generation Sequencing Can Help Define the Best Therapeutic Strategy for Brain
Zhonghui Ma1,2, Su Yan2,3, Haoxin Dong1,2
1Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Abstract:
Brain abscesses are associated with an increased long-term risk of new seizures and increased mortality within several years after infection. Common microorganisms that cause brain abscesses include bacteria, fungi, and mycoplasma. We report a 75-year-old man with a brain abscess caused by Prevotella denticola, an oral pathogen. Based on the clinical condition, we suspected that the patient had a blood-borne brain abscess, and he received antibiotics and systemic supportive treatment. The patient developed shock for the second time after negative Gram-staining results. Metagenomics next-generation sequencing showed one strain from the oral microbiome, confirming our hypothesis, and targeted antibiotic treatment was administered quickly. Thus, we report a case in which genomic analysis was the critical factor in determining the best antimicrobial therapy for administration.
Insights
Brain abscesses pose long-term risks. Metagenomics identified Prevotella denticola as the cause in a patient, enabling targeted antibiotic therapy for better outcomes.
Area of Science:
- Neurology
- Infectious Diseases
- Genomics
Background:
- Brain abscesses are serious infections linked to increased seizure risk and mortality.
- Typical causes include bacteria, fungi, and mycoplasma, but rare pathogens can occur.
Observation:
- A 75-year-old man presented with a brain abscess, initially suspected to be blood-borne.
- Despite antibiotic treatment, the patient experienced recurrent shock, and initial Gram staining was negative.
Findings:
- Metagenomics next-generation sequencing identified Prevotella denticola, an oral pathogen, as the causative agent.
- This genomic analysis confirmed the oral microbiome as the source and guided rapid, targeted antibiotic therapy.
Implications:
- Genomic analysis is crucial for diagnosing rare brain abscesses and selecting effective antimicrobial treatments.
- This case highlights the importance of advanced sequencing in identifying pathogens and optimizing patient care for brain infections.
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