The online version of this article (https://doi.org/10.1186/s12879-018-2946-7) contains supplementary material, which is available to authorized users.
We report a rare case of Mammalian orthoreovirus (MRV) infection in a child with a primary immunodeficiency (PID). Infections with Mammalian orthoreovirus are very rare and probably of zoonotic origin. Only a few cases have been described so far, including one with similar pathogenesis as in our case.
The patient, age 11, presented with flu-like symptoms and persistent severe diarrhea. Enterovirus has been detected over several months, however, exact typing of a positive cell culture remained inconclusive. Unbiased metagenomic sequencing then detected MRV in stool samples from several time points. The sequencing approach further revealed co-infection with a recombinant Coxsackievirus and Adenovirus. MRV-specific antibodies detected by immunofluorescence proved that the patient seroconverted.
This case highlights the potential of unbiased metagenomic sequencing in supplementing routine diagnostic methods, especially in situations of chronic infection with multiple viruses as seen here in an immunocompromised host. The origin, transmission routes and implications of MRV infection in humans merit further investigation.
Additional file 1: Portable Document Format. Table S1. Routine screening results for Enterovirus. Figures S1 to S9. Phylogenetic analyses of all Mammalian orthoreovirus segments isolated in this study. Figure S10. Coxsackievirus BLAST genotyping. Figure S11. Coxsackievirus Bootscan Analysis. Supplementary Methods. Supplementary References. (PDF 456 kb)12879_2018_2946_MOESM1_ESM.pdf
Lewandowska DW, Zagordi O, Zbinden A, Schuurmans MM, Schreiber P, Geissberger FD, Huder JB, Böni J, Benden C, Mueller NJ, et al. Unbiased metagenomic sequencing complements specific routine diagnostic methods and increases chances to detect rare viral strains. Diagn Microbiol Infect Dis. 2015;83(2):133–8. CrossRefPubMed
Steyer A, Gutierrez-Aguire I, Kolenc M, Koren S, Kutnjak D, Pokorn M, Poljsak-Prijatelj M, Racki N, Ravnikar M, Sagadin M, et al. High similarity of novel orthoreovirus detected in a child hospitalized with acute gastroenteritis to mammalian orthoreoviruses found in bats in Europe. J Clin Microbiol. 2013;51(11):3818–25. CrossRefPubMedPubMedCentral
Tyler KL, Barton ES, Ibach ML, Robinson C, Campbell JA, O’Donnell SM, Valyi-Nagy T, Clarke P, Wetzel JD, Dermody TS. Isolation and molecular characterization of a novel type 3 reovirus from a child with meningitis. J Infect Dis 2004;189(9):1664-1675.
Lelli D, Moreno A, Lavazza A, Bresaola M, Canelli E, Boniotti MB, Cordioli P. Identification of Mammalian orthoreovirus type 3 in Italian bats. Zoonoses Public Health. 2013;60(1):84–92.
- Persistent mammalian orthoreovirus, coxsackievirus and adenovirus co-infection in a child with a primary immunodeficiency detected by metagenomic sequencing: a case report
Dagmara W. Lewandowska
Jana Pachlopnik Schmid
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
e.Med Kampagnen-Visual, Mail Icon II