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Title: Case Report: Confirmation by Metagenomic Sequencing of Visceral Leishmaniasis in an Immunosuppressed Returned Traveler.
Austin Authors: Williams, Eloise;Isles, Nicole S;Seemann, Torsten;Kilpatrick, Trevor;Grigg, Andrew P ;Leroi, Marcel J ;Howden, Benjamin P ;Kwong, Jason C 
Affiliation: Infectious Diseases
Department of Anatomy and Neuroscience, The University of Melbourne, Parkville, Australia
The Florey Institute of Neuroscience and Mental Health, Parkville, Australia
Department of Neurology, Royal Melbourne Hospital, Parkville, Australia
Clinical Haematology
Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne, Peter Doherty Institute for Infection and Immunity, Parkville, Australia
Issue Date: Nov-2020
Date: 2020-09
Publication information: The American Journal of Tropical Medicine and Hygiene 2020; 103(5): 1930-1933
Abstract: There has been increased interest in using metagenomic next-generation sequencing as an unbiased approach for diagnosing infectious diseases. We describe a 61-year-old man on fingolimod therapy for multiple sclerosis with an extensive travel history who presented with 7 months of fevers, night sweats, and weight loss. Peripheral blood tests showed pancytopenia and abnormal acute phase reactants. A bone marrow aspirate showed the presence of numerous intracellular and extracellular amastigotes consistent with visceral leishmaniasis (VL). Metagenomic sequencing of the bone marrow aspirate confirmed Leishmania infantum, a species widely reported in the Mediterranean region. This correlated with acquisition of VL infection during the patient's most recent epidemiological exposure in southern Italy 12 months prior. This case demonstrates the potential application of metagenomic sequencing for identification and speciation of Leishmania in cases of VL; however, further assessment is required using other more readily obtained clinical samples such as blood.
DOI: 10.4269/ajtmh.19-0841
Journal: The American Journal of Tropical Medicine and Hygiene
PubMed URL: 32959759
Type: Journal Article
Appears in Collections:Journal articles

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