Clinicopathology conference: 41‐year‐old woman with chronic relapsing meningitis
Erin S. Beck MD, PhD Prashanth S. Ramachandran MBBS, BMedSci Lillian M. Khan BS Hannah A. Sample BS Kelsey C. Zorn MHS Elise M. O'Connell MD Theodore Nash MD Daniel S. Reich MD, PhD Arun Venkatesan MD, PhD Joseph L. DeRisi PhD Avindra Nath MD Michael R. Wilson MD, MASAnnuls of Neurology, 2018Abstract:
Despite the presumption of an autoimmune etiology, lingering concerns about an occult infection prompted enrollment of the patient in a research study at University of California, San Francisco to investigate her CSF with metagenomic next generation sequencing (mNGS), an unbiased approach to the identification of neuroinfectious diseases. The use of mNGS has gained momentum over the past several years, with several notable case reports and case series showcasing mNGS's ability to capture a broad range of infections with a single assay.24, 46-52 Total RNA is extracted from a patient's CSF, and complementary DNA (cDNA) is generated by reverse transcription with random hexamer primers.