{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T05:02:07Z","timestamp":1784523727382,"version":"3.55.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"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:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      The incidence of central nervous system (CNS) infections caused by\n                      <jats:italic>Listeria monocytogenes<\/jats:italic>\n                      is rising, yet it remains rarely reported and frequently misdiagnosed in patients with decompensated cirrhosis. This report evaluates the diagnostic utility of metagenomic next-generation sequencing (mNGS) in this specific population.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 62-year-old male with a 7-year history of cirrhosis presented with fever, headache, and loss of consciousness. At admission, the patient was in a decompensated state with a Child-Pugh score of 9 (Grade B) and a Model for End-Stage Liver Disease (MELD) score of 12, characterized by hypoalbuminemia and mild ascites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Diagnosis and intervention<\/jats:title>\n                    <jats:p>\n                      To avoid delayed treatment, broad-spectrum antibiotics were used before the results of blood and cerebrospinal fluid cultures were available. Preliminary cerebrospinal fluid (CSF) analysis showed an atypical inflammatory response in the context of cirrhosis-associated immune dysfunction. Although conventional CSF cultures remained negative, mNGS detected\n                      <jats:italic>Listeria monocytogenes<\/jats:italic>\n                      sequences within 16\u202fh. Early mNGS-guided targeted therapy, followed by multidisciplinary management under real-world drug availability constraints, was associated with significant clinical improvement and successful discharge.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cirrhosis-associated immune dysfunction (CAID) and hypersplenism can mask typical CSF diagnostic markers. mNGS provides a rapid, unbiased diagnostic paradigm that is crucial for shortening diagnostic duration and guiding precision therapy in immunocompromised hosts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1857949","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T04:21:05Z","timestamp":1784521265000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The value of mNGS in the diagnosis of central nervous system infections in immunodeficient hosts with decompensated cirrhosis complicated by Listeria encephalitis: Case Report"],"prefix":"10.3389","volume":"13","author":[{"given":"Linman","family":"Cao","sequence":"first","affiliation":[{"name":"Graduate School of Hebei Medical University","place":["Shijiazhuang, Hebei, China"]},{"name":"Hebei Provincial People's Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Hebei Provincial People's Hospital","place":["Shijiazhuang, Hebei, China"]},{"name":"Graduate School of Hebei North University","place":["Zhangjiakou, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongrong","family":"Wang","sequence":"additional","affiliation":[{"name":"Graduate School of Hebei Medical University","place":["Shijiazhuang, Hebei, China"]},{"name":"Hebei Provincial People's Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yijing","family":"Liu","sequence":"additional","affiliation":[{"name":"Hebei Provincial People's Hospital","place":["Shijiazhuang, Hebei, China"]},{"name":"Graduate School of North China University of Technology","place":["Tangshan, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linzheng","family":"Luo","sequence":"additional","affiliation":[{"name":"Graduate School of Hebei Medical University","place":["Shijiazhuang, Hebei, China"]},{"name":"Hebei Provincial People's Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Yan","sequence":"additional","affiliation":[{"name":"Hebei Provincial People's Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Li","sequence":"additional","affiliation":[{"name":"Hebei Provincial People's Hospital","place":["Shijiazhuang, Hebei, China"]},{"name":"Key Laboratory of Brain Networks and Cognitive Impairment Diseases","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1016\/j.jhep.2018.03.024","article-title":"EASL clinical practice guidelines for the management of patients with decompensated cirrhosis","volume":"69","year":"2018","journal-title":"J Hepatol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"53","DOI":"10.47026\/2413-4864-2023-1-53-62","article-title":"Characteristics of the immune status in patients with decompensation of liver 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