{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T12:44:06Z","timestamp":1774529046092,"version":"3.50.1"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T00:00:00Z","timestamp":1645056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004775","name":"Natural Science Foundation of Gansu Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004775","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Neurosci."],"abstract":"<jats:p>Japanese encephalitis (JE) is an acute viral central nervous system disease, although less than 1% of patients infected with Japanese encephalitis virus (JEV) result in JE, which has an extremely poor prognosis. The Routine detection methods for JEV are time-consuming or limited by hospital conditions, therefore, need the quicker and sensitive techniques to detect JEV. Here, we reported a 14-year-old female who was admitted to our hospital with a severe fever, progressively headache and unconsciousness. Based on the clinical presentation, Preliminary diagnosis on admission indicated central nervous system infection of suspected viral meningoencephalitis or autoimmune encephalitis. The patient's symptoms were unrelieved after being treated with empiric antiviral therapy. Magnetic resonance imaging (MRI) showed that the lesions were located in the bilateral thalamus, head of caudate nucleus, and right lenticular nucleus, so we had to consider the possibility of Flaviviruses infection. We sent the cerebrospinal fluid (CSF) for metagenomic next-generation sequencing (mNGS) immediately, subsequent result suggested the infection caused by JEV. Two days later the results of the serum agglutination test confirmed that virus immunoglobulin M antibody positive. After a week treatment with intravenous immunoglobulin (IVIG), meanwhile, the lumbar puncture was used to check the pressure and various indicators of the CSF again to evaluate the treatment effect, An decrease in the number of WBC indicates, protein and unique RNA reads that the previous experimental treatment was effective, accompany by temperature and consciousness of the patient was normalized. Two weeks after admission, the patient was transferred to the rehabilitation hospital, MR showed the lesions had disappeared completely after 2 months of follow-up. We believed that mNGS may be an effective method for rapid identification of JE.<\/jats:p>","DOI":"10.3389\/fncel.2022.856512","type":"journal-article","created":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T11:00:22Z","timestamp":1645095622000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Detection of Japanese Encephalitis by Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid: A Case Report and Literature Review"],"prefix":"10.3389","volume":"16","author":[{"given":"Xin","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guode","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manxia","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhang","family":"Jing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,2,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1016\/j.braindev.2019.04.005","article-title":"Longitudinal magnetic resonance imaging changes in Japanese encephalitis","volume":"41","author":"Arahata","year":"2019","journal-title":"Brain Dev"},{"key":"B2","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1080\/21505594.2021.1899674","article-title":"Pathogenicity and virulence of Japanese encephalitis virus: neuroinflammation and neuronal cell damage","volume":"12","author":"Ashraf","year":"2021","journal-title":"Virulence"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1915","DOI":"10.12688\/f1000research.19693.1","article-title":"Recent advances in understanding Japanese encephalitis","volume":"8","author":"Banerjee","year":"2019","journal-title":"F1000Res"},{"key":"B4","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.jns.2012.11.007","article-title":"Clinical and radiological spectrum of Japanese encephalitis","volume":"325","author":"Basumatary","year":"2013","journal-title":"J. Neurol. Sci"},{"key":"B5","doi-asserted-by":"publisher","first-page":"766","DOI":"10.2471\/BLT.10.085233","article-title":"Estimated global incidence of Japanese encephalitis: a systematic review","volume":"89","author":"Campbell","year":"2011","journal-title":"Bull. World Health Organ."},{"key":"B6","doi-asserted-by":"publisher","first-page":"723197","DOI":"10.3389\/fmed.2021.723197","article-title":"Case report: metagenomic next-generation sequencing confirmed a case of central nervous system infection with Brucella melitensis in non-endemic areas","volume":"8","author":"Cao","year":"2021","journal-title":"Front. Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1915","DOI":"10.1002\/glia.22857","article-title":"Disruption of in vitro endothelial barrier integrity by Japanese encephalitis virus-Infected astrocytes","volume":"63","author":"Chang","year":"2015","journal-title":"Glia"},{"key":"B8","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1007\/s13760-020-01433-z","article-title":"Phrenic nerve palsy in Japanese encephalitis: a rare association","volume":"121","author":"Chaudhuri","year":"2021","journal-title":"Acta Neurol. Belg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1150","DOI":"10.1128\/JVI.02738-13","article-title":"Infection of pericytes in vitro by Japanese encephalitis virus disrupts the integrity of the endothelial barrier","volume":"88","author":"Chen","year":"2014","journal-title":"J. Virol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s40794-017-0057-x","article-title":"The changing epidemiology of Japanese encephalitis and new data: the implications for new recommendations for Japanese encephalitis vaccine","volume":"3","author":"Connor","year":"2017","journal-title":"Trop. Dis. Travel Med. Vaccines"},{"key":"B11","doi-asserted-by":"publisher","first-page":"237","DOI":"10.4103\/aian.AIAN_309_19","article-title":"Acute flaccid myelitis caused by japanese encephalitis virus: a rare association","volume":"23","author":"Dev","year":"2020","journal-title":"Ann. Indian Acad. Neurol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1007\/s13365-020-00855-y","article-title":"Pseudorabies virus encephalitis in humans: a case series study","volume":"26","author":"Fan","year":"2020","journal-title":"J. Neurovirol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"111","DOI":"10.3390\/pathogens8030111","article-title":"Review of emerging japanese encephalitis virus: new aspects and concepts about entry into the brain and inter-cellular spreading","volume":"8","author":"Filgueira","year":"2019","journal-title":"Pathogens"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.1016\/j.cell.2018.02.025","article-title":"From \u201cA\u201dIV to \u201cZ\u201dIKV: attacks from emerging and re-emerging pathogens","volume":"172","author":"Gao","year":"2018","journal-title":"Cell"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e437","DOI":"10.1371\/journal.pntd.0000437","article-title":"Japanese encephalitis-a pathological and clinical perspective","volume":"3","author":"Ghosh","year":"2009","journal-title":"PLoS Negl. Trop. Dis"},{"key":"B16","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1159\/000510711","article-title":"Mixed upper and lower motor neuron damage in Japanese encephalitis virus infection","volume":"12","author":"Ghosh","year":"2020","journal-title":"Case Rep Neurol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1146\/annurev-pathmechdis-012418-012751","article-title":"Clinical metagenomic next-generation sequencing for pathogen detection","volume":"14","author":"Gu","year":"2019","journal-title":"Annu. Rev. Pathol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"E3","DOI":"10.3174\/ajnr.A0862","article-title":"MR imaging in biphasic Japanese encephalitis","volume":"29","author":"Handique","year":"2008","journal-title":"AJNR Am. J. Neuroradiol"},{"key":"B19","first-page":"1027","article-title":"Temporal lobe involvement in Japanese encephalitis: problems in differential diagnosis","volume":"27","author":"Handique","year":"2006","journal-title":"AJNR Am. J. Neuroradiol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"e1008260","DOI":"10.1371\/journal.ppat.1008260","article-title":"Japanese encephalitis virus and its mechanisms of neuroinvasion","volume":"16","author":"Hsieh","year":"2020","journal-title":"PLoS Pathog"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e22192","DOI":"10.1371\/journal.pone.0022192","article-title":"The spatial heterogeneity between Japanese encephalitis incidence distribution and environmental variables in Nepal","volume":"6","author":"Impoinvil","year":"2011","journal-title":"PLoS ONE"},{"key":"B22","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/1471-2377-12-43","article-title":"Japanese encephalitis accompanied by cerebral venous sinus thrombosis: a case report","volume":"12","author":"Jia","year":"2012","journal-title":"BMC Neurol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/j.jemermed.2007.02.042","article-title":"Diagnostic MR images of Japanese encephalitis","volume":"35","author":"Lai","year":"2008","journal-title":"J. Emerg. Med"},{"key":"B24","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1186\/s12974-017-0931-5","article-title":"Regulation of inflammation in Japanese encephalitis","volume":"14","author":"Lannes","year":"2017","journal-title":"J. Neuroinflammation"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e2208","DOI":"10.1371\/journal.pntd.0002208","article-title":"Review of climate, landscape, and viral genetics as drivers of the Japanese encephalitis virus ecology","volume":"7","author":"Le Flohic","year":"2013","journal-title":"PLoS Negl. Trop. Dis"},{"key":"B26","doi-asserted-by":"publisher","first-page":"682758","DOI":"10.3389\/fmed.2021.682758","article-title":"Case Report: diagnostic value of metagenomics next generation sequencing in intracranial infection caused by mucor","volume":"8","author":"Liu","year":"2021","journal-title":"Front. Med"},{"key":"B27","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.vetmic.2017.01.014","article-title":"Japanese encephalitis virus infection, diagnosis and control in domestic animals","volume":"201","author":"Mansfield","year":"2017","journal-title":"Vet. Microbiol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"4173","DOI":"10.1038\/s41598-017-02239-5","article-title":"Efficient and unbiased metagenomic recovery of RNA virus genomes from human plasma samples","volume":"7","author":"Manso","year":"2017","journal-title":"Sci. Rep"},{"key":"B29","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.coi.2015.10.008","article-title":"Mechanisms of restriction of viral neuroinvasion at the blood-brain barrier","volume":"38","author":"Miner","year":"2016","journal-title":"Curr. Opin. Immunol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.mcn.2018.04.002","article-title":"Brain microvascular endothelial-astrocyte cell responses following Japanese encephalitis virus infection in an in vitro human blood-brain barrier model","volume":"89","author":"Patabendige","year":"2018","journal-title":"Mol. Cell. Neurosci"},{"key":"B31","doi-asserted-by":"publisher","first-page":"20241","DOI":"10.2807\/ese.17.32.20241-en","article-title":"Does the Japanese encephalitis virus (JEV) represent a threat for human health in Europe? Detection of JEV RNA sequences in birds collected in Italy","volume":"17","author":"Platonov","year":"2012","journal-title":"Euro Surveill"},{"key":"B32","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1097\/00004728-200411000-00005","article-title":"Diffusion-weighted MR imaging in Japanese encephalitis","volume":"28","author":"Prakash","year":"2004","journal-title":"J. Comput. Assist. Tomogr"},{"key":"B33","doi-asserted-by":"publisher","first-page":"e51027","DOI":"10.7554\/eLife.51027","article-title":"Estimates of the global burden of Japanese encephalitis and the impact of vaccination from 2000\u20132015","volume":"9","author":"Quan","year":"2020","journal-title":"Elife"},{"key":"B34","doi-asserted-by":"publisher","first-page":"10832","DOI":"10.1038\/ncomms10832","article-title":"Vector-free transmission and persistence of Japanese encephalitis virus in pigs","volume":"7","author":"Ricklin","year":"2016","journal-title":"Nat. Commun"},{"key":"B35","doi-asserted-by":"publisher","first-page":"e251","DOI":"10.1212\/NXI.0000000000000251","article-title":"Next-generation sequencing in neuropathologic diagnosis of infections of the nervous system","volume":"3","author":"Salzberg","year":"2016","journal-title":"Neurol. Neuroimmunol. Neuroinflamm"},{"key":"B36","doi-asserted-by":"publisher","first-page":"381","DOI":"10.7883\/yoken.JJID.2019.332","article-title":"Acute flaccid paralysis as the initial manifestation of Japanese encephalitis: a case report","volume":"73","author":"Shen","year":"2020","journal-title":"Jpn. J. Infect. Dis"},{"key":"B37","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1093\/cid\/cix881","article-title":"Understanding the promises and hurdles of metagenomic next-generation sequencing as a diagnostic tool for infectious diseases","volume":"66","author":"Simner","year":"2018","journal-title":"Clin Infect Dis"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1483","DOI":"10.1056\/NEJMc1701600","article-title":"Autochthonous Japanese Encephalitis with yellow fever coinfection in Africa","volume":"376","author":"Simon-Loriere","year":"2017","journal-title":"N. Engl. J. Med"},{"key":"B39","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1056\/NEJMp058263","article-title":"Control of Japanese encephalitis\u2013within our grasp?","volume":"355","author":"Solomon","year":"2006","journal-title":"N. Engl. J. Med"},{"key":"B40","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1007\/s10072-013-1579-2","article-title":"Secondary cervical dystonic tremor after Japanese encephalitis","volume":"35","author":"Spagnolo","year":"2014","journal-title":"Neurol. Sci"},{"key":"B41","doi-asserted-by":"publisher","first-page":"2243","DOI":"10.2169\/internalmedicine.0337-17","article-title":"A Japanese encephalitis patient presenting with parkinsonism with corresponding laterality of magnetic resonance and dopamine transporter imaging findings","volume":"57","author":"Tadokoro","year":"2018","journal-title":"Intern. Med"},{"key":"B42","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1002\/mdc3.12074","article-title":"Slow mandibulo-faciolingual wiggling tremor associated with Japanese encephalitis","volume":"1","author":"Takeuchi","year":"2014","journal-title":"Mov. Disord. Clin. Pract"},{"key":"B43","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1055\/s-0038-1675607","article-title":"Japanese encephalitis virus-induced anti-N-methyl-D-aspartate receptor encephalitis: a case report and review of literature","volume":"50","author":"Tian","year":"2019","journal-title":"Neuropediatrics"},{"key":"B44","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1146\/annurev.ento.54.110807.090510","article-title":"Ecology and geographical expansion of Japanese encephalitis virus","volume":"54","author":"van den Hurk","year":"2009","journal-title":"Annu. Rev. Entomol"},{"key":"B45","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1007\/s13365-019-00816-0","article-title":"Genome-based analysis of SFTSV causing severe encephalitis with brain lesions","volume":"26","author":"Wang","year":"","journal-title":"J. Neurovirol"},{"key":"B46","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1016\/S0140-6736(20)30185-9","article-title":"A novel coronavirus outbreak of global health concern","volume":"395","author":"Wang","year":"","journal-title":"Lancet"},{"key":"B47","doi-asserted-by":"publisher","first-page":"117080","DOI":"10.1016\/j.jns.2020.117080","article-title":"Clinical features of adult anti-N-methyl-d-aspartate receptor encephalitis after Japanese encephalitis","volume":"417","author":"Wang","year":"2020","journal-title":"J. Neurol. Sci"},{"key":"B48","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1056\/NEJMc1916977","article-title":"Guillain-Barr\u00e9 syndrome associated with JEV infection","volume":"383","author":"Wang","year":"2020","journal-title":"N. Engl. J. Med"},{"key":"B49","doi-asserted-by":"publisher","first-page":"435","DOI":"10.2147\/TCRM.S51168","article-title":"Epidemiology of Japanese encephalitis: past, present, and future prospects","volume":"11","author":"Wang","year":"2015","journal-title":"Ther. Clin. Risk Manag"},{"key":"B50","doi-asserted-by":"publisher","first-page":"2327","DOI":"10.1056\/NEJMoa1803396","article-title":"Clinical metagenomic sequencing for diagnosis of meningitis and encephalitis","volume":"380","author":"Wilson","year":"2019","journal-title":"N. Engl. J. Med"},{"key":"B51","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1089\/vim.2014.0049","article-title":"Guillain-Barr\u00e9 syndrome associated with Japanese encephalitis virus infection in China","volume":"27","author":"Xiang","year":"2014","journal-title":"Viral Immunol"},{"key":"B52","doi-asserted-by":"publisher","first-page":"20242","DOI":"10.2807\/ese.17.32.20242-en","article-title":"Is Japanese encephalitis emerging in Europe?","volume":"17","author":"Zeller","year":"2012","journal-title":"Euro Surveill"}],"container-title":["Frontiers in Cellular Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fncel.2022.856512\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T11:00:25Z","timestamp":1645095625000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fncel.2022.856512\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,17]]},"references-count":52,"alternative-id":["10.3389\/fncel.2022.856512"],"URL":"https:\/\/doi.org\/10.3389\/fncel.2022.856512","relation":{},"ISSN":["1662-5102"],"issn-type":[{"value":"1662-5102","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,17]]},"article-number":"856512"}}