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Disclosures None Meningoencephalitis: Next-Generation Approaches - - PowerPoint PPT Presentation

2/12/2015 Disclosures None Meningoencephalitis: Next-Generation Approaches


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SLIDE 1

2/12/2015 1

Meningoencephalitis: Next-Generation Approaches

  • Disclosures

None

Talk Overview

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Acute Encephalitis Burden: U.S.

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SLIDE 2

2/12/2015 2

Encephalitis of Unknown Etiology

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Why Is Diagnosis So Difficult?

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Traditional Diagnostic Techniques

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Tissue Sample RNA/DNA Fragment and PCR Amplify Illumina Sequence

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SLIDE 3

2/12/2015 3

Raw Sequence Remove Human Use the remainder to search all of GenBank Match “hits” to taxonomy “bowtie” “gsnapl” MySQL “CASAVA” Very Fast alignment - uses the Burroughs Wheeler Transform Base-caller Fast alignment to very large sequence collections Database lookups

NGS: Three Niches to Fill

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SLIDE 4

2/12/2015 4

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SLIDE 5

2/12/2015 5

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SLIDE 6

2/12/2015 6

  • Histoplasma Ag
  • Blastomyces Ag
  • Bartonella PCR
  • Cryptococcal Ag
  • Adenovirus
  • CMV, HSV, EBV, VZV
  • HHV-6, 7, 8
  • Influenza A, B
  • Respiratory syncytial virus
  • JC virus
  • Mumps virus
  • Aspergillus Ag
  • Toxoplasma gondii
  • Parvovirus B19
  • West Nile virus
  • Borrelia Burgdorferi PCR
  • Parainfluenza virus
  • Metapneumovirus
  • Enterovirus/Rhinovirus
  • Coronavirus
  • Bocavirus
  • Powassan virus
  • CA Encephalitis virus
  • Fungal culture
  • Bacterial culture
  • 16s rRNA PCR
  • BK virus
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SLIDE 7

2/12/2015 7

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SLIDE 8

2/12/2015 8

Case #2

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SLIDE 9

2/12/2015 9

Case #2

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Case #2

Ampicillin Cefepime Metronidazole Vancomycin Sulfadiazine Pyrimethamine Rifampin Isoniazid Pyrazinamide Ethambutol Moxifloxacin Prednisone Amphotericin B

Necrotizing Vasculitis Case #2

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SLIDE 10

2/12/2015 10

Necrotizing Vasculitis Immunohistochemistry

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Cyst Form

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SLIDE 11

2/12/2015 11

Trophozoite

UCSF Meningitis and Encephalitis Center

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Acknowledgements

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SLIDE 12

2/12/2015 12

Epilogue

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