{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T06:05:58Z","timestamp":1774677958264,"version":"3.50.1"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T00:00:00Z","timestamp":1582070400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T00:00:00Z","timestamp":1582070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the national science and technology major project of China","award":["2018ZX10305409-001-001"],"award-info":[{"award-number":["2018ZX10305409-001-001"]}]},{"DOI":"10.13039\/501100001809","name":"national natural science foundation of China","doi-asserted-by":"crossref","award":["81701973"],"award-info":[{"award-number":["81701973"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"project of Jiangsu province medical youth talent","award":["QNRC2016059"],"award-info":[{"award-number":["QNRC2016059"]}]},{"DOI":"10.13039\/501100019349","name":"Nanjing medical science and technique development foundation","doi-asserted-by":"crossref","award":["ZKX17040"],"award-info":[{"award-number":["ZKX17040"]}],"id":[{"id":"10.13039\/501100019349","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Shenzhen city science and technology development project","award":["JCYJ20160425105735113"],"award-info":[{"award-number":["JCYJ20160425105735113"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Varicella-zoster virus (VZV) infection can be diagnosed clinically once classical rash occurs but the diagnosis is challenging when typical rash is absent. We reported a case of fulminant central nervous system (CNS) VZV infection in a human immunodeficiency virus (HIV)-infected patient without typical VZV-related rash. CNS VZV infection was unexpected identified by metagenomic next-generation sequencing (mNGS).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A 28-year-old HIV-infected patient presented with neurological symptoms for 3\u2009days. The patient, who was not suspected of VZV infection at admission, quickly progressed to deep coma during the first 24\u2009h of hospitalization. An unbiased mNGS was performed on DNA extract from 300\u2009\u03bcL cerebrospinal fluid (CSF) with the BGISEQ-50 platform. The sequencing detection identified 97,248 (out of 38,561,967) sequence reads uniquely aligned to the VZV genome, and these reads covered a high percentage (99.91%) of the VZV. Presence of VZV DNA in CSF was further verified by VZV-specific polymerase chain reaction and Sanger sequencing. Altogether, those results confirmed CNS VZV infection.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This study suggests that mNGS may be a useful diagnostic tool for CNS VZV infection. As mNGS could identify all pathogens directly from CSF sample in a single run, it has the promise of strengthening our ability to diagnose CNS infections in HIV-infected patients.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12879-020-4872-8","type":"journal-article","created":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T15:02:54Z","timestamp":1582124574000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Fulminant central nervous system varicella-zoster virus infection unexpectedly diagnosed by metagenomic next-generation sequencing in an HIV-infected patient: a case report"],"prefix":"10.1186","volume":"20","author":[{"given":"Mingxia","family":"Fang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xing","family":"Weng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liyun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaling","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun","family":"Chi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1526-4677","authenticated-orcid":false,"given":"Wei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiliang","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,2,19]]},"reference":[{"issue":"sup3","key":"4872_CR1","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1586\/erv.10.30","volume":"9","author":"RW Johnson","year":"2010","unstructured":"Johnson RW. Herpes zoster and postherpetic neuralgia. Exp Rev Vaccines. 2010;9(sup3):21\u20136.","journal-title":"Exp Rev Vaccines"},{"key":"4872_CR2","doi-asserted-by":"publisher","first-page":"15016","DOI":"10.1038\/nrdp.2015.16","volume":"1","author":"AA Gershon","year":"2015","unstructured":"Gershon AA, Breuer J, Cohen JI, Cohrs RJ, Gershon MD, Gilden D, Grose C, Hambleton S, Kennedy PG, Oxman MN, et al. Varicella zoster virus infection. Nat Rev Dis Primers. 2015;1:15016.","journal-title":"Nat Rev Dis Primers"},{"issue":"5","key":"4872_CR3","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1093\/cid\/cix881","volume":"66","author":"PJ Simner","year":"2018","unstructured":"Simner PJ, Miller S, Carroll KC. Understanding the promises and hurdles of metagenomic next-generation sequencing as a diagnostic tool for infectious diseases. 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This study was approved by the institutional review boards of the Second Hospital of Nanjing (reference number: 2019-LY-kt074).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written consent for case publication was obtained on the patient\u2019s behalf from his father.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"159"}}