Application of metagenomic next-generation sequencing in the diagnosis of Bartonella neuroretinitis: a case report and literature review
Abstract Background Cat-scratch disease (CSD) is caused by Bartonella henselae infection. In atypical cases of CSD, pathogen determination is challenging. We report a case of Bartonella neuroretinitis with neither a clear history of scratches nor typical general symptoms. The diagnosis was made usin...
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| Formato: | Artigo |
| Idioma: | English |
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SpringerOpen
2024-04-01
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| Series: | Journal of Ophthalmic Inflammation and Infection |
| Subjects: | |
| Acceso en liña: | https://doi.org/10.1186/s12348-024-00387-0 |
| _version_ | 1827276948051591168 |
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| author | Pengcheng Li Zhuyun Qian Yong Tao |
| author_facet | Pengcheng Li Zhuyun Qian Yong Tao |
| author_sort | Pengcheng Li |
| collection | DOAJ |
| description | Abstract Background Cat-scratch disease (CSD) is caused by Bartonella henselae infection. In atypical cases of CSD, pathogen determination is challenging. We report a case of Bartonella neuroretinitis with neither a clear history of scratches nor typical general symptoms. The diagnosis was made using metagenomic next-generation sequencing (mNGS), a high-throughput sequencing technology. Case presentation A female patient presented to the ophthalmologist with complaint of blurred vision in her right eye. Although with history of raising a cat, she reported no clear history of scratches or typical general symptoms, except a fever of unknown origin which resolved spontaneously. The best corrected visual acuity (BCVA) of the right eye was count fingers. Fundus examination showed optic disc oedema, macular exudates and inferior exudative retinal detachment. Laboratory examination results showed increased value of serum C-reactive protein and erythrocyte sedimentation rate. Ocular involvement of toxoplasmosis, syphilis and tuberculosis were excluded. To identify the possible causative pathogen of the disease, mNGS of aqueous humour sample was performed and 521 reads of B. henselae were identified. Serological test results further showed a positive immunoglobulin G (IgG) titre of 1:64. Taking the contact history, clinical manifestations, mNGS and serological results into consideration, the diagnosis of Bartonella neuroretinitis (ocular CSD) was made. After appropriate treatment, the BCVA of the right eye improved to 20/25 in the last follow-up. Fundus examination showed a normal optic disc and macula, and the exudates had reduced. Conclusion mNGS, a fast and unbiased method, can be used to detect B. henselae (if present) in intraocular fluid samples.; however, the results should be interpreted together with the clinical symptoms and other auxiliary test results. |
| first_indexed | 2024-04-24T07:12:37Z |
| format | Article |
| id | doaj.art-165b6092974e4f74b15bda69ef8a830e |
| institution | Directory Open Access Journal |
| issn | 1869-5760 |
| language | English |
| last_indexed | 2024-04-24T07:12:37Z |
| publishDate | 2024-04-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Ophthalmic Inflammation and Infection |
| spelling | doaj.art-165b6092974e4f74b15bda69ef8a830e2024-04-21T11:27:08ZengSpringerOpenJournal of Ophthalmic Inflammation and Infection1869-57602024-04-011411710.1186/s12348-024-00387-0Application of metagenomic next-generation sequencing in the diagnosis of Bartonella neuroretinitis: a case report and literature reviewPengcheng Li0Zhuyun Qian1Yong Tao2Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyBeijing GIANTMED Medical Diagnostics LabDepartment of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, No. 8, South Road of Worker’s Stadium Chaoyang DistrictAbstract Background Cat-scratch disease (CSD) is caused by Bartonella henselae infection. In atypical cases of CSD, pathogen determination is challenging. We report a case of Bartonella neuroretinitis with neither a clear history of scratches nor typical general symptoms. The diagnosis was made using metagenomic next-generation sequencing (mNGS), a high-throughput sequencing technology. Case presentation A female patient presented to the ophthalmologist with complaint of blurred vision in her right eye. Although with history of raising a cat, she reported no clear history of scratches or typical general symptoms, except a fever of unknown origin which resolved spontaneously. The best corrected visual acuity (BCVA) of the right eye was count fingers. Fundus examination showed optic disc oedema, macular exudates and inferior exudative retinal detachment. Laboratory examination results showed increased value of serum C-reactive protein and erythrocyte sedimentation rate. Ocular involvement of toxoplasmosis, syphilis and tuberculosis were excluded. To identify the possible causative pathogen of the disease, mNGS of aqueous humour sample was performed and 521 reads of B. henselae were identified. Serological test results further showed a positive immunoglobulin G (IgG) titre of 1:64. Taking the contact history, clinical manifestations, mNGS and serological results into consideration, the diagnosis of Bartonella neuroretinitis (ocular CSD) was made. After appropriate treatment, the BCVA of the right eye improved to 20/25 in the last follow-up. Fundus examination showed a normal optic disc and macula, and the exudates had reduced. Conclusion mNGS, a fast and unbiased method, can be used to detect B. henselae (if present) in intraocular fluid samples.; however, the results should be interpreted together with the clinical symptoms and other auxiliary test results.https://doi.org/10.1186/s12348-024-00387-0NeuroretinitisBartonella henselaecat-scratch diseaseMetagenomic next-generation sequencingCase report |
| spellingShingle | Pengcheng Li Zhuyun Qian Yong Tao Application of metagenomic next-generation sequencing in the diagnosis of Bartonella neuroretinitis: a case report and literature review Journal of Ophthalmic Inflammation and Infection Neuroretinitis Bartonella henselae cat-scratch disease Metagenomic next-generation sequencing Case report |
| title | Application of metagenomic next-generation sequencing in the diagnosis of Bartonella neuroretinitis: a case report and literature review |
| title_full | Application of metagenomic next-generation sequencing in the diagnosis of Bartonella neuroretinitis: a case report and literature review |
| title_fullStr | Application of metagenomic next-generation sequencing in the diagnosis of Bartonella neuroretinitis: a case report and literature review |
| title_full_unstemmed | Application of metagenomic next-generation sequencing in the diagnosis of Bartonella neuroretinitis: a case report and literature review |
| title_short | Application of metagenomic next-generation sequencing in the diagnosis of Bartonella neuroretinitis: a case report and literature review |
| title_sort | application of metagenomic next generation sequencing in the diagnosis of bartonella neuroretinitis a case report and literature review |
| topic | Neuroretinitis Bartonella henselae cat-scratch disease Metagenomic next-generation sequencing Case report |
| url | https://doi.org/10.1186/s12348-024-00387-0 |
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