Metagenomic next-generation sequencing for the etiological diagnosis of rabies virus in cerebrospinal fluid

• Published in: Frontiers in medicine Vol. 10; p. 982290
• Main Authors: Liu, Yong, Mo, Xichao, Feng, Ye, Willoughby, Rodney E, Weng, Xing, Wang, Yuyang, Li, Xing, Gao, Junling, Tian, Jinfei, Peng, Jie
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 09.02.2023
• Subjects: cerebrospinal fluid; diagnosis; Medicine; metagenomic next-generation sequencing; rabies; rabies virus; rabies virus; diagnosis; rabies; metagenomic next-generation sequencing; cerebrospinal fluid
• ISSN: 2296-858X; 2296-858X
• DOI: 10.3389/fmed.2023.982290

Rabies is a highly fatal disease. Once symptoms develop, death usually occurs within days. Survivors were occasionally reported in the literatures. Ante-mortem diagnosis remains a challenge in most rabies endemic countries. A novel, accurate diagnostic assay is highly desirable. We used metagenomic next-generation sequencing (mNGS) to examine the cerebrospinal fluid (CSF) samples of a 49-year-old patient with rabies and validated the results by TaqMan PCR and RT-PCR/Sanger sequencing. Metagenomic next-generation sequencing identified sequence reads uniquely aligned to the rabies virus (RABV). PCR confirmed the presence of the partial RABV N gene in the CSF. Phylogenetic analysis showed that the RABV grouped as an Asian clade, which is the most broadly distributed clade in China. Metagenomic next-generation sequencing may be a useful screening tool for the etiological diagnosis of rabies, especially in the absence of timely rabies laboratory testing or in patients with no exposure history.