Clinical Report: Utilizing mNGS for Diagnosing CNS Infections in Cirrhosis

Background

Central nervous system infections caused by Listeria monocytogenes are increasingly recognized, particularly in immunocompromised patients such as those with decompensated cirrhosis. The diagnostic challenges in this population are compounded by cirrhosis-associated immune dysfunction, which can obscure typical clinical markers.

Data Highlights

No numerical data or trial data was provided in the article.

Key Findings

• A 62-year-old male with decompensated cirrhosis presented with fever, headache, and altered consciousness.
• Conventional cerebrospinal fluid (CSF) cultures were negative, but mNGS identified Listeria monocytogenes within 16 hours.
• The patient's Child-Pugh score was 9 (Grade B) and MELD score was 12 at admission.
• Broad-spectrum antibiotics were initiated prior to mNGS results to avoid treatment delays.
• Early mNGS-guided therapy was associated with significant clinical improvement and successful discharge.

Clinical Implications

Clinicians should consider mNGS as a diagnostic option in cases of suspected Listeria infections, especially in patients with cirrhosis.

Conclusion

mNGS provides a rapid diagnostic method for identifying CNS infections in immunocompromised patients.

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2. Frontiers in Medicine, 2026 -- Case Report: Beyond conventional diagnostics: mNGS support in a complex immunocompromised patient diagnosis
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9. https://academic.oup.com/cid/article/82/Supplement_4/S92/8678931?rss=1
10. A Multicenter Evaluation of Metagenomic Sequencing for Pathogen Detection in Central Nervous System Infections - ScienceDirect
11. Mild encephalitis/encephalopathy with reversible corpus callosum lesion associated with listeria infection with meningoencephalitis: a case report - PubMed