AUTHOR=Xing Xiao-Wei , Yu Su-Fei , Zhang Jia-Tang , Tan Rui-Shu , Ma Yu-Bao , Tian Xia , Wang Rong-Fei , Yao Guo-En , Cui Fang , Gui Qiu-Ping , Yu Sheng-Yuan 

TITLE=Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid for the Diagnosis of Cerebral Aspergillosis

JOURNAL=Frontiers in Microbiology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2021.787863

DOI=10.3389/fmicb.2021.787863

ISSN=1664-302X

ABSTRACT=Purpose: Cerebral aspergillosis (CA) is a rare but often fatal opportunistic infection that remains difficult to diagnose. The application of metagenomic next-generation sequencing (mNGS) in the diagnosis of CA remains poorly characterized. Here, we evaluated the usefulness of mNGS performed on CSF for the diagnosis of CA. 
Methods: This prospective study involved seven consecutive patients with confirmed CA in whom CSF mNGS was performed. A comparison of serum (1→3)-β-D-glucan, serum galactomannan, histopathological examination and mNGS of CSF were conducted.
Results: mNGS of CSF was positive in six of the seven confirmed CA, i.e. 85.7% sensitivity. In the CM group, which was used as control group, mNGS of CSF was positive for Aspergillus in two patients, i.e. 84.6%specificity. Among the six mNGS positive cases, more than two Aspergillus species were found in four (4/6, 66.67%) cases. 
Conclusions: mNGS is helpful for the diagnosis of CA and may reduce the need for cerebral biopsy in patients with suspected CA.