Case Report: Confirmation by Metagenomic Sequencing of Visceral Leishmaniasis in an Immunosuppressed Returned Traveler
Eloise Williams, Nicole S Isles, Torsten Seemann, Trevor Kilpatrick, Andrew Grigg, Marcel Leroi, Benjamin P Howden, Jason C Kwong
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE | AMER SOC TROP MED & HYGIENE | Published : 2020
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..View full abstract
Awarded by CASS Foundation
Awarded by Centre for Research Excellence in Emerging Infectious Diseases
Awarded by National Health and Medical Research Council of Australia
This work was supported by grants from the Austin Medical Research Foundation and the CASS Foundation (reference no. 7113). J. C. K. (GNT1142613 and Centre for Research Excellence in Emerging Infectious Diseases GNT1102962) and B. P. H. (GNT1105905) are supported by the National Health and Medical Research Council of Australia.