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Demonstrate the utility of metagenomic next-generation sequencing for diagnosing rabies virus infection in an atypical clinical presentation lacking known animal exposure.

February 24, 2025BMC Infectious DiseasesOpen Access

Metagenomic next-generation sequencing for etiological diagnosis of an unexpected rabies case with unclear exposure history

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Demonstrate the utility of metagenomic next-generation sequencing for diagnosing rabies virus infection in an atypical clinical presentation lacking known animal exposure.
Evaluated a 49-year-old female presenting with non-specific agitation, pruritus, and respiratory distress without typical hydrophobia or known bite history.
Performed pathogen screening via culture and mNGS on cerebrospinal fluid, blood, and saliva samples, followed by confirmatory RT-qPCR and phylogenetic analysis of partial L and G viral genes.
Initial blood and cerebrospinal fluid cultures and mNGS yielded negative results, whereas subsequent saliva mNGS and confirmatory RT-qPCR successfully detected rabies virus nucleic acids.
Phylogenetic analysis identified the virus as China I lineage, showing 99.7% sequence similarity with the canine Fengtai strain, prior to the patient's death from multiple organ failure on hospital day 10.

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Implication

Case report demonstrates detection of rabies virus via saliva metagenomic sequencing in an atypical patient, highlighting its utility when classic clinical signs and bite history are absent.

Cite This Study

Wu et al. (2025) studied this question.

synapsesocial.com/papers/6a90ffbb3fe4db18257446bc https://doi.org/10.1186/s12879-025-10687-y

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Implication

Case report demonstrates detection of rabies virus via saliva metagenomic sequencing in an atypical patient, highlighting its utility when classic clinical signs and bite history are absent.

Metagenomic next-generation sequencing for etiological diagnosis of an unexpected rabies case with unclear exposure history

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Discussion

Implication

Cite This Study

Metagenomic next-generation sequencing for etiological diagnosis of an unexpected rabies case with unclear exposure history

Key Points

Discussion

Implication

Cite This Study

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