Letter to the Editor
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2022; 10(33): 12455-12457
Published online Nov 26, 2022. doi: 10.12998/wjcc.v10.i33.12455
Diagnostic value of metagenomics next-generation sequencing technology in disseminated strongyloidiasis
Peng Song, Xia Li
Peng Song, Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, Shandong Province, China
Xia Li, Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
Author contributions: Song P designed research; Li X analyzed data; Song P wrote the letter; and Li X revised the letter; all authors read and approved the final manuscript.
Conflict-of-interest statement: Author(s) certify that there is no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xia Li, MD, Professor, Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Huaiyin street, Jinan 250021, Shandong Province, China. lxia0718@163.com
Received: July 18, 2022
Peer-review started: July 18, 2022
First decision: September 25, 2022
Revised: October 4, 2022
Accepted: October 31, 2022
Article in press: October 31, 2022
Published online: November 26, 2022

The symptoms of disseminated strongyloidiasis are not typical, and it is difficult for clinicians to identify strongyloidiasis in some non-endemic areas. We report a 70-year-old woman who was diagnosed with Guillain-Barré syndrome due to autonomic disturbance, symmetrical bulbar palsy, and lower-motor-nerve damage in the extremities; her symptoms continued to worsen after hormone and immunoglobulin therapy. Later, parasitic larvae were found in the patient’s gastric fluid, and metagenomic next generation sequencing (mNGS) detection of bronchoalveolar-lavage fluid also found a large number of Strongyloides roundworms. The patient was diagnosed with disseminated strongyloidiasis. The patient was given albendazole for anthelmintic treatment, but died two days after being transferred to the intensive care unit due to the excessive strongyloidiasis burden. In recent years, mNGS has been increasingly used in clinical practice, and is becoming the main means of detecting strongyloides stercoralis in non-endemic areas. Especially during the corona virus disease 2019 pandemic, mNGS technology has irreplaceable value in identifying the source of infection.

Keywords: Metagenomics, Next-generation sequencing, Disseminated, Strongyloidiasis

Core Tip: Metagenomic next-generation sequencing (mNGS) has a high sensitivity in identifying pathogen species. As a new pathogenic detection method, it plays an irreplaceable role in unexplained infectious diseases. It can provide important information for clinicians to identify new pathogens, non-tuberculosis mycobacteria and parasites. With the continuous improvement of clinical laboratory diagnostic technology, mNGS has been used more and more widely in clinical practice, and has become the main means to identify parasites in non-endemic areas.