关键词: 广州管圆线虫脑膜炎； 外周血宏基因二代测序； 诊断； 儿童

Abstract: Objective To explore the feasibility of blood metagenomic next-generation sequencing-based diagnosis of Angiostrongylus cantonensis （AC） meningitis in children. Methods The blood and cerebrospinal fluid (CSF) of the children diagnosed as intracranial infection in the Department of Neurology, Shenzhen Children's Hospital from July 2017 to December 2019 were simultaneously sent to Shenzhen Huada Gene Company for mNGS examination. And comprehensive analysis was performed on the clinical data and mNGS results of children with AC meningitis. Results Two cases of AC meningitis were confirmed among the 65 children with blood and CSF sent for mNGS examination. Case one was an 11 -month-old female infant, and Case two was a 20 -month-old male infant. Both of the two cases were misdiagnosed at the beginning of the disease, and had a history of exposure to uncooked freshwater aquatic products, and were in critical condition and underwent long-term PICU hospitalization. The eosinophil ratio in the blood and CSF of two cases was significantly increased, and the brain MRI enhanced scan of two cases showed meningeal enhancement. In case one, AC was detected in both blood and CSF mNGS, and the sequence number was 90 and 4059 , respectively. In case one, AC was also detected in both blood and CSF mNGS, and the sequence number was 529 and 718 , respectively. The two cases were cured after treatment with albendazole and low dose glucocorticoid. Conclusion Blood mNGS examination is expected to be a non-invasive, rapid and accurate new method for the diagnosis of AC meningitis in children.