Case Report: Detection of Treponema phagedenis in cerebrospinal fluid of a neurosyphilis patient by metagenomic next-generation sequencing

Chenyan Yuan; Wei Xu; Chenggui Zhao; Wei Gao; Guoqiu Wu

doi:10.3389/fcimb.2023.1218049

Case Report: Detection of Treponema phagedenis in cerebrospinal fluid of a neurosyphilis patient by metagenomic next-generation sequencing

Front Cell Infect Microbiol. 2023 Aug 29:13:1218049. doi: 10.3389/fcimb.2023.1218049. eCollection 2023.

Authors

Chenyan Yuan^{1

2}, Wei Xu^{1

2}, Chenggui Zhao^{1

2}, Wei Gao^{1

2}, Guoqiu Wu^{1

2

3}

Affiliations

¹ Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China.
² Department of Laboratory Medicine, Medical School of Southeast University, Nanjing, Jiangsu, China.
³ Jiangsu Provincial Key Laboratory of Critical Care Medicine, Southeast University, Nanjing, Jiangsu, China.

Abstract

Treponema phagedenis, a human commensal spirochete, has been reported world-wide as a key factor in the pathogenesis of bovine digital dermatitis. Here we report a case of T. phagedenis sequence detection in the cerebrospinal fluid (CSF) of a patient. The patient was diagnosed with neurosyphilis, and T. phagedenis was detected as the only microorganism in his CSF by metagenomic sequencing. The patient went through a round of penicillin therapy previously (2.4 million units of Benzathine Penicillin intramuscularly once a week for three weeks) that did not resolve the symptoms; after the diagnosis of neurosyphilis he was treated with Penicillin G Sodium 4.0 million units q4h intravenous for 14 days then his symptoms resolved. To the best of our knowledge, T. phagedenis has never been reported to be detected in a human's CSF before. This was also the first time it was detected by metagenomic next-generation sequencing. We propose that more etiological tests should be performed including culture and sequencing for more patients with syphilis, which will contribute to a deeper understanding of the pathogenicity of the spirochete.

Keywords: Treponema phagedenis; case report; cerebrospinal fluid; etiological tests; neurosyphilis.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Animals
Cattle
High-Throughput Nucleotide Sequencing
Humans
Male
Neurosyphilis* / diagnosis
Penicillin G Benzathine
Treponema* / genetics

Substances

Penicillin G Benzathine

Supplementary concepts

Treponema phagedenis

Grants and funding

This work was supported by grants from the National Science and Technology Major Project (No. 2020ZX09201015), Jiangsu Provincial Medical Key Laboratory (JSDW202240), and Jiangsu Provincial Key Laboratory of Critical Care Medicine (JSKLCCM202202015).