{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T06:36:00Z","timestamp":1775025360736,"version":"3.50.1"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>This report describes a confirmed rabies case with no clear exposure history. A 68-year-old female was hospitalized due to chest tightness and shortness of breath, subsequently developing typical symptoms including agitation, photophobia, and hydrophobia, requiring transfer to the ICU. The family denied any animal bite history, and physical examination revealed only superficial marks on the left knee. Probe-capture targeted next-generation sequencing (tNGS) of bronchoalveolar lavage fluid (BALF) detected 279 rabies virus sequences, confirmed by Sanger sequencing. The patient ultimately succumbed to circulatory and respiratory failure after the family withdrew life support. This case demonstrates that probe-capture tNGS can serve as an effective tool for diagnosing rabies in living patient without typical exposure using BALF samples.<\/jats:p>","DOI":"10.3389\/fmed.2026.1766261","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T04:36:01Z","timestamp":1775018161000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Targeted next-generation sequencing confirms rabies in a patient with unknown exposure: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Runqi","family":"Li","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, Affiliated Hospital of Nantong University, Nantong","place":["Jiangsu, China"]},{"name":"School of Medicine, Nantong University, Nantong","place":["Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenmiao","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Affiliated Hospital of Nantong University, Nantong","place":["Jiangsu, China"]},{"name":"School of Medicine, Nantong University, Nantong","place":["Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhongqi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Affiliated Hospital of Nantong University, Nantong","place":["Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dinfectome Inc., Nanjing","place":["Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinlong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Affiliated Hospital of Nantong University, Nantong","place":["Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.13201\/j.issn.1009-5918.2019.09.001","article-title":"Expert consensus on treatment of dog bites (2019).","volume":"28","year":"2019","journal-title":"Chin J Emerg Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"786953","DOI":"10.3389\/fimmu.2021.786953","article-title":"Lyssaviruses and the fatal encephalitic disease rabies.","volume":"12","author":"Scott","year":"2021","journal-title":"Front. Immunol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1080\/13550280701883857","article-title":"Furious and paralytic rabies of canine origin: neuroimaging with virological and cytokine studies.","volume":"14","author":"Laothamatas","year":"2008","journal-title":"J Neurovirol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"373","DOI":"10.3760\/cma.j.cn112866-20240403-00055","article-title":"Analysis of epidemic characteristics of human rabies in China in 2007\u20132023","volume":"38","author":"Yao","year":"2024","journal-title":"Chin J Exp Clin Virol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e0013159","DOI":"10.1371\/journal.pntd.0013159","article-title":"Exploring one health-based strategies for rabies elimination: overview and future prospects.","volume":"19","author":"Zha","year":"2025","journal-title":"PLoS Negl Trop Dis."},{"key":"B6","doi-asserted-by":"publisher","first-page":"48","DOI":"10.4103\/ijmr.ijmr_131_23","article-title":"Recent updates on laboratory diagnosis of rabies.","volume":"159","author":"Ashwini","year":"2024","journal-title":"Indian J Med Res."},{"key":"B7","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1186\/s12879-025-10687-y","article-title":"Metagenomic next-generation sequencing for etiological diagnosis of an unexpected rabies case with unclear exposure history.","volume":"25","author":"Wu","year":"2025","journal-title":"BMC Infect Dis."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1276","DOI":"10.1016\/j.jiph.2022.10.003","article-title":"A new choice for human rabies diagnosis: a case report of metagenomics next-generation sequencing in diagnosis of human rabies.","volume":"15","author":"Pin","year":"2022","journal-title":"J Infect Public Health."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1321515","DOI":"10.3389\/fmed.2023.1321515","article-title":"Targeted next-generation sequencing for pulmonary infection diagnosis in patients unsuitable for bronchoalveolar lavage.","volume":"10","author":"Deng","year":"2023","journal-title":"Front Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"e127","DOI":"10.1016\/j.jinf.2022.08.022","article-title":"Targeted next generation sequencing is comparable with metagenomic next generation sequencing in adults with pneumonia for pathogenic microorganism detection.","volume":"85","author":"Li","year":"2022","journal-title":"J Infect."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e0052622","DOI":"10.1128\/jcm.00526-22","article-title":"Evaluation of metagenomic and targeted next-generation sequencing workflows for detection of respiratory pathogens from bronchoalveolar lavage fluid specimens.","volume":"60","author":"Gaston","year":"2022","journal-title":"J Clin Microbiol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.ejim.2021.04.010","article-title":"Rabies in Europe: an epidemiological and clinical update.","volume":"88","author":"Riccardi","year":"2021","journal-title":"Eur J Intern Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1578939","DOI":"10.3389\/fcimb.2025.1578939","article-title":"Comparison of the diagnostic capabilities of tNGS and mNGS for pathogens causing lower respiratory tract infections: a prospective observational study.","volume":"15","author":"Ding","year":"2025","journal-title":"Front Cell Infect Microbiol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"27365","DOI":"10.1038\/s41598-025-11834-w","article-title":"Comparative diagnostic performance of metagenomic and two targeted sequencing methods in lower respiratory infection.","volume":"15","author":"Yi","year":"2025","journal-title":"Sci Rep."},{"key":"B15","doi-asserted-by":"publisher","first-page":"967","DOI":"10.3390\/idr14060095","article-title":"Intravitam diagnosis of rabies in patients with acute encephalitis: a study of two cases.","volume":"14","author":"Singhai","year":"2022","journal-title":"Infect Dis Rep."},{"key":"B16","doi-asserted-by":"publisher","first-page":"982290","DOI":"10.3389\/fmed.2023.982290","article-title":"Metagenomic next-generation sequencing for the etiological diagnosis of rabies virus in cerebrospinal fluid.","volume":"10","author":"Liu","year":"2023","journal-title":"Front Med."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1766261\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T04:36:16Z","timestamp":1775018176000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1766261\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,1]]},"references-count":16,"alternative-id":["10.3389\/fmed.2026.1766261"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1766261","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,1]]},"article-number":"1766261"}}