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Accurate and early diagnosis of NCC remains challenging due to its heterogeneous clinical manifestations, neuroimaging deficits, variable sensitivity, and specificity of serological tests. Next-generation sequencing (NGS)-based pathogen analysis in patient\u2019s cerebrospinal fluid (CSF) with NCC infection has recently been reported indicating its diagnostic efficacy. In this case study, we report the diagnosis of a NCC patient with a symptomatic history of over 20\u2009years using NGS analysis and further confirmation of the pathology by immunological tests.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>This study reports the clinical imaging and immunological features of a patient with a recurrent headache for more than 20\u2009years, which worsened gradually with the symptom of fever for more than 7\u2009years and paroxysmal amaurosis for more than 1 year. By utilizing NGS technique, the pathogen was detected in patient\u2019s CSF, and the presence of <jats:italic>Taenia solium<\/jats:italic>-DNA was confirmed by a positive immunological reaction to cysticercus IgG antibody in CSF and serum samples. The symptoms of the patient were alleviated, and the CSF condition was improved substantially after the anti-helminthic treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study suggests that combining CSF NGS with cysticercus IgG testing may be a highly promising approach for diagnosing the challenging cases of NCC. Further studies are needed to evaluate the parasitic DNA load in patients\u2019 CSF for the diagnosis of disease severity, stage, and monitoring of therapeutic responses.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12883-021-02277-7","type":"journal-article","created":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T06:02:54Z","timestamp":1624514574000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Next-generation sequencing combined with serological tests based pathogen analysis for a neurocysticercosis patient with a 20-year history:a case report"],"prefix":"10.1186","volume":"21","author":[{"given":"Bin","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-shu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gui-lan","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-jiao","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong-zhi","family":"Guan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hai-tao","family":"Ren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hou-zhen","family":"Tuo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,6,24]]},"reference":[{"issue":"12","key":"2277_CR1","doi-asserted-by":"publisher","first-page":"1202","DOI":"10.1016\/S1474-4422(14)70094-8","volume":"13","author":"HH Garcia","year":"2014","unstructured":"Garcia HH, Nash TE, Del Brutto OH. 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A copy of the written consent is available for review by the editor of this journal. All presentations of case reports must have consent for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declared no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"236"}}