Candida tropicalis Brain Abscess Diagnosed by Metagenomic Next-generation Sequencing

Area of Science:

• Neuroscience
• Infectious Diseases
• Genomics

Background:

• Brain abscesses can be challenging to diagnose, especially when conventional microbiological methods fail to identify the causative pathogen.
• Vasculitis-associated stroke can sometimes lead to secondary complications like brain abscesses, posing diagnostic difficulties in immunocompetent individuals.

Purpose of the Study:

• To report a case of brain abscess secondary to vasculitis-associated stroke in an HIV-negative male.
• To highlight the diagnostic utility of metagenomic next-generation sequencing (mNGS) in culture-negative central nervous system (CNS) infections.

Main Methods:

• Clinical presentation of a 59-year-old male with stroke and subsequent brain abscess.
• Conventional diagnostic methods including culture and rapid multiplex PCR were employed.
• Metagenomic next-generation sequencing (mNGS) was performed on abscess tissue obtained via craniotomy and biopsy.

Main Results:

• Conventional methods failed to identify the causative pathogen in the brain abscess.
• Metagenomic next-generation sequencing (mNGS) successfully identified Candida tropicalis as the causative agent.
• The patient was diagnosed with a brain abscess attributed to Candida tropicalis following vasculitis-associated stroke.

Conclusions:

• Metagenomic next-generation sequencing (mNGS) is a valuable tool for diagnosing challenging, culture-negative CNS infections, particularly brain abscesses.
• This case underscores the importance of advanced molecular techniques when standard microbiological investigations are inconclusive.
• Candida tropicalis can be a causative agent of brain abscesses, even in immunocompetent individuals following cerebrovascular events.