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A difficult case
Neurocysticercosis: diagnosis via metagenomic next-generation sequencing
  1. Denison Alves Pedrosa1,
  2. Gustavo Bruniera Peres Fernandes2,
  3. Luís Filipe de Souza Godoy3,
  4. André C Felício1,
  5. João Rebello Pinho2,
  6. André Mário Doi2,
  7. René de Araújo Gleizer1
  1. 1 General Neurology Division, Albert Einstein Israeli Institute of Education and Research, São Paulo, Brazil
  2. 2 Research and Development Sector, Clinical Laboratory, Albert Einstein Israeli Institute of Education and Research, São Paulo, Brazil
  3. 3 Department of Radiology, Albert Einstein Israeli Institute of Education and Research, São Paulo, Brazil
  1. Correspondence to Dr René de Araújo Gleizer, General Neurology Division, Albert Einstein Israeli Institute of Education and Research, Sao Paulo, Brazil; rgleizer1986{at}gmail.com

Abstract

A 68-year-old Brazilian woman had 3 months of progressive fatigue, difficulty walking and 18 kg weight loss. On examination, there was gait apraxia and executive dysfunction. MR scan of brain showed communicating hydrocephalus and a cerebrospinal fluid showed 105 white cells/µL (≤5), predominantly lymphocytes, protein of 1.35 g/L (0.15–0.45) and the glucose content of 0.06 mmol/L (3.3–4.4). We suspected an infective cause and used of metagenomic next-generation sequencing to diagnose neurocysticercosis. This case highlights the challenge of diagnosing chronic meningitis and the relevance of genetic approaches in diagnosing neurological infections.

  • APRAXIA
  • COGNITION
  • CSF
  • GAIT
  • INFECTIOUS DISEASES

Data availability statement

Data are available in a public, open access repository.

https://doi.org/10.1136/pn-2023-003795

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    Data availability statement

    Data are available in a public, open access repository.

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    Footnotes

    • Correction notice This article has been corrected since it was published Online First. An author last name and initials in the contributors section have been updated.

    • Contributors DAP: drafting/revision of the manuscript for content, including medical writing for content; major role in the acquisition of data; study concept or design; analysis or interpretation of data; GBPF: major role in the acquisition of data; Analysis or interpretation of data; LFdSG: drafting/revision of the manuscript for content, including medical writing for content; major role in the acquisition of data; study concept or design; analysis or interpretation of data; ACF: drafting/revision of the manuscript for content, including medical writing for content; major role in the acquisition of data; study concept or design; analysis or interpretation of data; JRP: major role in the acquisition of data; analysis or interpretation of data; AMD: major role in the acquisition of data; analysis or interpretation of data; RdAG: drafting/revision of the manuscript for content, including medical writing for content; major role in the acquisition of data; study concept or design; analysis or interpretation of data.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned. Externally peer reviewed by Hadi Manji, London, UK.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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