Diagnosis of Streptococcus suis Meningoencephalitis with metagenomic next-generation sequencing of the cerebrospinal fluid: a case report with literature review

BMC Infect Dis. 2020 Nov 25;20(1):884. doi: 10.1186/s12879-020-05621-3.


Background: Streptococcus suis meningoencephalitis is a zoonotic disease that mostly infects slaughterhouse workers. Rapid diagnosis of Streptococcus suis meningoencephalitis is critical for effective clinical management of this condition. However, the current diagnostic techniques are not effective for early diagnosis of this condition. To the best of our knowledge, the use of cerebrospinal fluid metagenomic next generation sequencing in the diagnosis of Streptococcus suis meningoencephalitis has been rarely reported.

Case presentation: Here, we report a case of Streptococcus suis meningoencephalitis in a 51-year-old female patient. The patient had a history of long-term contact with pork and had a three-centimeter-long wound on her left leg prior to disease onset. Conventional tests, including blood culture, gram staining and cerebrospinal fluid culture, did not reveal bacterial infection. However, Streptococcus suis was detected in cerebrospinal fluid using metagenomic next generation sequencing.

Conclusions: Metagenomic next generation sequencing is a promising approach for early diagnosis of central nervous system infections. This case report indicates that cases of clinical meningeal encephalitis of unknown cause can be diagnosed through this method.

Keywords: Cerebrospinal fluid; Meningoencephalitis; Metagenomic next-generation sequencing; Streptococcus suis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Ceftazidime / therapeutic use
  • Early Diagnosis
  • Encephalitis
  • Female
  • Follow-Up Studies
  • High-Throughput Nucleotide Sequencing / methods*
  • Humans
  • Meningoencephalitis / cerebrospinal fluid*
  • Meningoencephalitis / diagnosis*
  • Meningoencephalitis / drug therapy
  • Meningoencephalitis / microbiology
  • Middle Aged
  • Streptococcal Infections / cerebrospinal fluid*
  • Streptococcal Infections / diagnosis*
  • Streptococcal Infections / drug therapy
  • Streptococcal Infections / microbiology
  • Streptococcus suis / genetics*
  • Treatment Outcome
  • Zoonoses / cerebrospinal fluid*
  • Zoonoses / diagnosis*
  • Zoonoses / drug therapy
  • Zoonoses / microbiology


  • Anti-Bacterial Agents
  • Ceftazidime