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ORIGINAL RESEARCH article

Front. Microbiol.
Sec. Systems Microbiology
Volume 15 - 2024 | doi: 10.3389/fmicb.2024.1463822
This article is part of the Research Topic Artificial Intelligence and mNGS in Pathogenic Microorganism Research. View all articles

Utilizing Metagenomic Next-Gener ation Sequencing and Phylogenetic Analysis to Identify a Rar e Pediatr ic Case of Naegleria fowleri Infection Pr esenting with Fulminant Myocar ditis

Provisionally accepted
Liangkang Lin Liangkang Lin 1,2Lili Luo Lili Luo 1,3Mei Wu Mei Wu 1,3Jun Chen Jun Chen 1,3Yi Liao Yi Liao 3,4Haiyang Zhang Haiyang Zhang 1,3*
  • 1 Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
  • 2 Department of Pediatrics, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
  • 3 Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan Province, China
  • 4 Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan Province, China

The final, formatted version of the article will be published soon.

    Backgr ound: Naegleria fowleri (N. fowleri), a rare and typically lethal amoeba, most commonly causes primary amoebic meningoencephalitis (PAM). This case report describes an exceptionally rare presentation of fulminant myocarditis as the primary manifestation in a six-year-old child, diverging from the typical neurological pathogenesis associated with N. fowleri infection. Beyond neurological afflictions, the child developed arrhythmias and cardiac failure, necessitating treatment with extracorporeal membrane oxygenation (ECMO).Methods: Diagnosis was confirmed via metagenomic next-generation sequencing (mNGS) of both blood and cerebrospinal fluid (CSF). This analysis not only substantiated the infection but also revealed a potential new genotype of N. fowleri, designated k39_3, suggesting broader genetic diversity than previously recognized.Results: Immediate treatment with Amphotericin B (Am B) and rifampin was initiated upon diagnosis. Despite aggressive management and supportive care, the patient failed to maintain hemodynamic stability, continued to show a decrease in cardiac output, and exhibited relentless progression of central nervous system failure, culminating in death within 72 hours. Conclusion: Our report documents a rare pediatric case of N. fowleri infection presenting with fulminant myocarditis, revealing an unexpected clinical manifestation and broadening the known spectrum of its effects. This emphasizes the need for enhanced surveillance and targeted research to understand the pathogenic mechanisms and improve treatment strategies.

    Keywords: Fulminant myocarditis, Primary amoebic meningoencephalitis, metagenomic next-generation sequencing, Naegleria fowleri, phylogenetic analysis

    Received: 12 Jul 2024; Accepted: 28 Oct 2024.

    Copyright: © 2024 Lin, Luo, Wu, Chen, Liao and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Haiyang Zhang, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China

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