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

▶
disclosures
SMART_READER_LITE
LIVE PREVIEW

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

Nov 29, 2022 260 likes •390 views

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

slide-1
SLIDE 1

2/12/2015 1

Meningoencephalitis: Next-Generation Approaches

  • Disclosures

None

Talk Overview

  • !"#$%&'

– (!

Acute Encephalitis Burden: U.S.

  • )****+
  • ,)
  • -./
  • 0*. 123"
  • 04.
  • 3 )*0567)8559"5:0
slide-2
SLIDE 2

2/12/2015 2

Encephalitis of Unknown Etiology

  • ;:*. )-50

– !

  • (<=

– 4 $0:4*'8-9.

  • % >)*0*64:8?)5"?9)
  • %(@(2)**-65980:-:"0:44

Why Is Diagnosis So Difficult?

  • ;0**
  • 2/A

– @" – 3 – (/

Traditional Diagnostic Techniques

  • 3"
  • @/
  • 3

– 1 – –

  • B @(2)**765489*9"9)4

Tissue Sample RNA/DNA Fragment and PCR Amplify Illumina Sequence

slide-3
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

0' 2//

  • )' 2/

9' 2#

  • <%>)**769:78??0"??7
  • & )*0)6058**07*"0)
  • ((C(2)**-659840"4-
  • 05" /
  • @
  • < )

– #23

Case #1

  • >)*05694*8)5*7")504
  • 05" /
  • @
  • < )

– #23

  • /
  • Case #1
  • >)*05694*8)5*7")504
slide-4
SLIDE 4

2/12/2015 4

  • D<

– &

  • D<

– &

  • D/=/
  • B
  • (//)

– <$' – (!$' – !2B<

  • D/D
  • D/D
  • @-/

0*9D

/

  • / "

– "/ – (/ – / – /

slide-5
SLIDE 5

2/12/2015 5

  • &/
  • E
  • 2
  • : /0
  • (

– 0):F9$07.:). ' – *F9 – <?4F – %)5F – %/

  • 2
  • @/ "
  • /
  • B/

/

  • )!/
  • (&D

– 0*?($0-. 97. ' – *( – <0-)F – %04F – %/

slide-6
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
slide-7
SLIDE 7

2/12/2015 7

  • B23
  • !/
  • &#

"

  • G(&D

/!" #

  • 57H
  • >)*05694*8)5*7")504
  • 23
  • )
slide-8
SLIDE 8

2/12/2015 8

Case #2

  • 45
  • #
  • 3
  • B /

"!

  • Case #2
  • (B

/

  • % -B
  • &
slide-9
SLIDE 9

2/12/2015 9

Case #2

  • (&D

– 954($:4.<90.00. 0.' – 09( – %9*F – <40F

Case #2

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

Necrotizing Vasculitis Case #2

  • @!:** (&D
  • )*******
  • 0:***"
  • 00???.
slide-10
SLIDE 10

2/12/2015 10

Necrotizing Vasculitis Immunohistochemistry

  • (((I

Balamuthia mandrillaris

  • D0?7-
  • ;)**
  • !
  • 5///G&
  • &D(2)**?657874?"774

Cyst Form

slide-11
SLIDE 11

2/12/2015 11

Trophozoite

UCSF Meningitis and Encephalitis Center

  • (
  • 8 J
  • 1&8J

Acknowledgements

  • – >

– %I – & – (+ – >1 – >I – 1&

  • ((
  • B B
  • @@(

BD

  • G(&D(B&2I)@
  • 112
  • – &1

– >% – ( – 3= – @% – &< – D( – % – – @ > – &

slide-12
SLIDE 12

2/12/2015 12

Epilogue

  • ((<(