Abstract Details

Title The Diagnosis of Pseudorabies Virus Encephalitis and Endophthalmitis by Next Generation Sequencing in Two Chinese Pork Retailers

Topic Infectious Disease

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-019

Objective Not applicable

Background

The alphaherpesvirus PRV is the causative agent of Aujeszky's disease, which has major economic impact in swine husbandry. Previous studies showed PRV has several secondary mammalian hosts, except for human. In early 2018, China reported the first PRV caused human infectious endophthalmitis through directly contaminated with sewage containing pig excrement.

Design/Methods

Case reports.

Results (1)A previously healthy 27-year-old female pork retailer presented to hospital for high fever, psychosis and generalized tonic-clonic seizures in mid-October, 2011. Brain MRI on day 10 showed DWI hyperintense lesions in bilateral insular lobes and basal ganglia, with leptomengeal enhancement. Lumbar puncture revealed elevated pressure (27cm H₂O), protein concentration (60 mg/dl) and pleocytosis (36×10⁶/L). Although CSF viral PCR negative, empiric use of acyclovir was started for possible herpes simplex virus encephalitis. She accepted endotracheal intubation for mechanical ventilation due to status epilepticus. Bedside funduscopy revealed bilateral necrotizing retinitis. MRI on day 40 showed multiple T2 / T2 Flair hyperintense lesions in bilateral frontal, temporal, parietal and insular lobes as well as basal ganglia. The patient died on day 53. In January 2018, NGS showed 64 unique sequence reads of PRV in her archived CSF, covering 4.9% of the nucleotide sequences

(2)A post encephalitis 49-year-old pork retailor presented to ophthalmology clinic for bilateral retinal detachment. Brain MRI in acute phase (4 months ago) showed T2 and DWI hyperintense lesions in right temporal lobes and splenial corpus callosum. Two months ago, his visual acuity started to decreased. NGS showed 153 unique sequence reads of PRV in vitreous humor, covering 4.33% of the nucleotide sequences with CSF negative.

Conclusions

Not mandatory PRV vaccine, neurotropic properties of virus and contacting flesh with wounds on hand make PRV infected case increasingly reported in China. NGS is powerful in facilitating the diagnosis of previously unknown pathogens.

Authors/Disclosures
Lei Liu, MD, PhD (Beijing Tongren Hospital,Capital Medical University) PRESENTER	Dr. Liu has nothing to disclose.
	No disclosure on file

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