Meningitis and epididymitis caused by Toscana virus infection imported to Switzerland diagnosed by metagenomic sequencing: a case report

Autor: Verena Kufner, Michael Huber, Riccarda Capaul, Fiona Pigny, Yvonne Achermann, Fabian Tschumi, Stefan Schmutz, Maike Heider, Bettina Schreiner
Přispěvatelé: University of Zurich, Huber, Michael
Rok vydání: 2019
Předmět:
10028 Institute of Medical Virology
Adult
Male
0301 basic medicine
viruses
030106 microbiology
610 Medicine & health
Case Report
Antibodies
Viral
Bunyaviridae Infections
Rubella
lcsh:Infectious and parasitic diseases
Serology
10234 Clinic for Infectious Diseases
Young Adult
03 medical and health sciences
0302 clinical medicine
medicine
Viral meningitis
Humans
Meningitis
lcsh:RC109-216
030212 general & internal medicine
Toscana virus
Epididymitis
Clinical metagenomics
biology
Sequence Analysis
RNA
business.industry
Tick-borne encephalitis
Meningoencephalitis
Sandfly fever Naples virus
2725 Infectious Diseases
medicine.disease
biology.organism_classification
Meningitis
Viral
Virology
10040 Clinic for Neurology
Infectious Diseases
Italy
Molecular Diagnostic Techniques
RNA
Viral
Metagenomics
business
Switzerland
Encephalitis
Zdroj: BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-4 (2019)
BMC Infectious Diseases
ISSN: 1471-2334
Popis: Background We report a rare case of Toscana virus infection imported into Switzerland in a 23-year old man who travelled to Imperia (Italy) 10 days before onset of symptoms. Symptoms included both meningitis and as well epididymitis. This is only the fourth case of Toscana virus reported in Switzerland. Case presentation The patient presented with lymphocytic meningitis and scrotal pain due to epididymitis. Meningitis was initially treated with ceftriaxone. Herpes simplex, tick-borne encephalitis, enterovirus, measles, mumps, rubella and Treponema pallidum were excluded with specific polymerase chain reaction (PCR) or serology. In support of routine diagnostic PCR and serology assays, unbiased viral metagenomic sequencing was performed of cerebrospinal fluid and serum. Toscana virus infection was identified in cerebrospinal fluid and the full coding sequence could be obtained. Specific PCR in cerebrospinal fluid and blood and serology with Immunoglobulin (Ig) M and IgG against Toscana virus confirmed our diagnosis. Neurological symptoms recovered spontaneously after 5 days. Conclusions This case of Toscana virus infection highlights the benefits of unbiased metagenomic sequencing to support routine diagnostics in rare or unexpected viral infections. With increasing travel histories of patients, physicians should be aware of imported Toscana virus as the agent for viral meningitis and meningoencephalitis. Electronic supplementary material The online version of this article (10.1186/s12879-019-4231-9) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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