{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T06:28:33Z","timestamp":1771655313758,"version":"3.50.1"},"reference-count":13,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,3,31]],"date-time":"2016-03-31T00:00:00Z","timestamp":1459382400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Department of Pediatrics, Washington University School of Medicine"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A 40\u2010year\u2010old man with chronic myelogenous leukemia presented multiple times over a period of 3 years with episodes of confusion, wide\u2010based gait and falls because of recurrent hydrocephalus despite repeated therapeutic lumbar punctures. These problems occurred in the context of persistent cerebrospinal fluid (<jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content>) pleocytosis and leptomeningeal enhancement. Extensive diagnostic workups and therapeutic trials had failed to identify a clinically plausible cause or produce any significant improvement in the <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> and neuroimaging abnormalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used high\u2010throughput metagenomic shotgun sequencing to identify microbes in 2 <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> samples collected from the patient during his illness. These results were compared to sequence data from 1 <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> sample collected during treatment and 5 control <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> samples from other patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found sequences representing 53% and 67% of the <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>ropionibacterium acnes<\/jats:italic> genome in 2 <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> samples collected from the patient during his illness. Directed antimicrobial therapy was administered for 6 weeks with resolution of <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> and neuroimaging abnormalities. Sequencing of a sample obtained during treatment demonstrated that the <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>. acnes<\/jats:italic> levels were decreased to background levels. After insertion of a ventriculo\u2010peritoneal shunt, the patient returned to baseline status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High\u2010throughput metagenomic shotgun sequencing revealed <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>. acnes<\/jats:italic> as the cause of chronic meningitis that had eluded conventional attempts at diagnosis. Treatment directed at this organism resulted in cure of the infection and clinical improvement.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12512","type":"journal-article","created":{"date-parts":[[2016,2,20]],"date-time":"2016-02-20T21:10:16Z","timestamp":1456002616000},"page":"227-233","source":"Crossref","is-referenced-by-count":24,"title":["High\u2010throughput sequencing of cerebrospinal fluid for diagnosis of chronic <i><scp>P<\/scp>ropionibacterium acnes<\/i> meningitis in an allogeneic stem cell transplant recipient"],"prefix":"10.1111","volume":"18","author":[{"given":"K.M.","family":"Wylie","sequence":"first","affiliation":[{"name":"Department of Pediatrics Washington University School of Medicine St. Louis Missouri USA"},{"name":"The McDonnell Genome Institute Washington University School of Medicine St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Blanco\u2010Guzman","sequence":"additional","affiliation":[{"name":"Department of Medicine Washington University School of Medicine St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.N.","family":"Wylie","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Washington University School of Medicine St. Louis Missouri USA"},{"name":"The McDonnell Genome Institute Washington University School of Medicine St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.J.","family":"Lawrence","sequence":"additional","affiliation":[{"name":"Department of Medicine Washington University School of Medicine St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Ghobadi","sequence":"additional","affiliation":[{"name":"Department of Medicine Washington University School of Medicine St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.F.","family":"DiPersio","sequence":"additional","affiliation":[{"name":"Department of Medicine Washington University School of Medicine St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.A.","family":"Storch","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Washington University School of Medicine St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,3,31]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-anchem-062012-092628"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1401268"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu912"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00193-14"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btp324"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btp352"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1040-8428(00)00115-3"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1100330"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1086\/588298"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02755-13"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmoldx.2015.07.004"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1101\/gr.171934.113"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkv002"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftid.12512","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.12512","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T16:47:48Z","timestamp":1695574068000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.12512"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,3,31]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,4]]}},"alternative-id":["10.1111\/tid.12512"],"URL":"https:\/\/doi.org\/10.1111\/tid.12512","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,3,31]]}}}